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中国临床药理学与治疗学 ›› 2012, Vol. 17 ›› Issue (9): 1052-1056.

• 药物治疗学 • 上一篇    下一篇

麻黄碱联合丙泊酚抑制芬太尼咳嗽反射的临床研究

张志永1, 谢彬2, 虞雪融1, 黄宇光1   

  1. 1中国医学科学院中国协和医科大学北京协和医院麻醉科,北京 100730;
    2内蒙古自治区赤峰市敖汉旗医院麻醉科,赤峰 024300,内蒙古
  • 收稿日期:2012-06-07 修回日期:2012-07-07 发布日期:2012-09-25
  • 通讯作者: 黄宇光,通信作者,男,教授,主任医师,博士生导师,主要研究方向:临床麻醉与镇痛、疼痛分子生物学机制研究与基因治疗、危重病人及心脏病人非心脏手术的麻醉、围术期血液保护与合理用血。Tel: 010-69155580 E-mail: pumchhyg@yahoo.com.cn
  • 作者简介:张志永,男,博士研究生,主要研究方向:临床麻醉与镇痛。Tel: 010-69154278 E-mail: zzyo169@sina.com

Effects of ephedrine and propofol on fentanyl-induced cough during induction of general anesthesia

ZHANG Zhi-yong1, XIE Bin2, YU Xue-rong1, HUANG Yu-guang1   

  1. 1Department of Anesthesiology,Peking Union Medical College Hospital,CAMS & PUMC,Beijing 100730,China;;
    2Department of Anesthesiology, Aohan Qi Hospital,Chifeng 024300, Inner Mongolia,China
  • Received:2012-06-07 Revised:2012-07-07 Published:2012-09-25

摘要: 目的 研究麻黄碱联合丙泊酚对芬太尼咳嗽反射(fentanyl-induced cough,FIC)的抑制作用。方法 选择320例择期手术接受全麻的患者,根据计算机随机数字表随机进入4组:Ⅰ组(对照组)静脉注射 2 mL 生理盐水;Ⅱ组(麻黄碱组)静脉注射 6 mg 麻黄碱;Ⅲ组(丙泊酚组)静脉注射 0.8 mg/kg 丙泊酚;Ⅳ组(丙泊酚联合麻黄碱组)静脉注射 0.8 mg/kg 丙泊酚加 6 mg 麻黄碱。给予治疗药物 2 min 后,经外周静脉快速注射 2 μg/kg 芬太尼。观察并记录患者的血压、心率、脉博血氧饱和度等生命体征, 并由一位医师按照盲法观察注射芬太尼后 1 min 内是否出现咳嗽,记录咳嗽发生的次数,并且根据咳嗽发生次数进行严重程度分级。结果 Ⅱ组、Ⅲ组和Ⅳ组患者的FIC发生率和严重程度均较Ⅰ组明显降低,而且Ⅳ组患者的血流动力学更加平稳。结论 麻醉诱导时联合应用麻黄碱和丙泊酚对FIC的抑制效果更好,患者血流动力学更加稳定,是临床上一个简单、有效的防治FIC的办法。

关键词: 芬太尼, 咳嗽, 麻黄碱, 丙泊酚, 血流动力学

Abstract: AIM: To evaluate the effectiveness of ephdrine, propofol and ephedrine combined with propofol on fentanyl-induced cough during anesthesia induction. METHODS: 320 patients with ASA Ⅰ or Ⅱ for elective procedures were randomly assigned into four groups and the following medications were administered intravenously: patients in Group I(control group) received normal saline 2 mL, Group II (ephedrine group) received ephedrine 6 mg, Group III (propofol group) received propofol 0.8 mg/kg and Group IV (ephedrine plus propofol group) received ephedrine 6 mg plus propofol 0.8 mg/kg . At one minute after the study medication, fentanyl 2.0 μg/kg was given intravenously within two seconds. The occurrence of cough and vital sign profiles were recorded within one minutes after fentanyl bolus.RESULTS: The incidence of FIC was 42.5% in group I, 18.8% in group II, 20.0% in group III, and 2.5% in group IV, respectively. Lower incidence and less severity of cough were observed in groups II, III, and IV than those in group I (P<0.05). Groups IV had a lower incidence and less severity of cough than those in group II and group III (P<0.05). Hemodynamics was more stable in group IV than that in other groups.CONCLUSION: Intravenous ephedrine 6 mg plus propofol 0.8 mg/kg could prevent fentanyl-induced cough effectively. lt is a convenient method to suppress fentanyl-induced cough with stable hemodynamics in this setting.

Key words: Fentanyl, Cough, Ephedrine, Propofol, Hemodynamic

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