摘要:
目的：观察预注地佐辛对不同推注速度下舒芬太尼引发咳嗽反应，并探讨更平稳的全麻诱导方法。方法选择200例择期行全麻手术患者，年龄20～65岁，ASAⅠ～Ⅱ级，随机分为4组，每组50例。Ⅰ、Ⅱ（试验组）于诱导前静注地佐辛0．1 mg /kg（用生理盐水稀释至5 mL），Ⅲ、Ⅳ组（对照组）则注射生理盐水5 mL。5 min 后各组进行全麻诱导，其中Ⅰ、Ⅲ组为快推注组，推注舒芬太尼0．5μg /kg，推注时间5 s；Ⅱ、Ⅳ组为慢推注组，推注舒芬太尼0．5μg /kg，推注时间30 s。观察记录推注舒芬太尼后2 min 内咳嗽的发生率和强度。记录插管前后 SBP、DBP 和 HR 的变化。结果4组插管前后 SBP、DBP 和HR 比较差异无统计学意义（P ＞0．05）。Ⅰ、Ⅱ组咳嗽发生率明显比Ⅳ组低（P ＜0．01），Ⅳ组咳嗽发生率也比Ⅲ组低（P ＜0．05），差异有统计学意义。结论推注速度可影响舒芬太尼引起咳嗽反应的发生，预先注入地佐辛能有效地降低不同推注速度舒芬太尼引发咳嗽的发生率，尤以慢推注组明显，是麻醉诱导更平稳的好方法。
关键词:
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地佐辛
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全麻
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舒芬太尼
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咳嗽反射
Abstract:
Objective To observe preinjection of dezocine on different injection speed on induced cough response.Methods 200 undergoing general anesthesia operation patients with ASA Ⅰ~Ⅱ were randomly divided into four groups,each group with 50 people.Ⅰ,Ⅱ (experi-mental group)were injected before induction of intravenous dezocine 0.1 mg /kg (diluted with nor-mal saline to 5 mL),Ⅲ,Ⅳ (control group)were injected with physiological saline 5 mL.General anesthesia were inducted after 5 minutes in each group,including Ⅰ,Ⅲ group as fast injection group,infusion of sufentanil 0.5 μg /kg with 5s injection time;Ⅱ,Ⅳ group was slow injection group with infusion of sufentanil 0.5μg /kg,injection time was 30 s.Incidence and intensity of in-fusion of sufentanil after 2 min cough were observed and recorded.The changes of SBP,DBP and HR before and after tracheal intubation were record.Results Difference in SBP,DBP and HR was no significant before and after intubation in four groups (P >0.05).The incidence of cough inⅠ,Ⅱ group was significantly more than the Ⅳ group (P <0.01),the difference was statistically significant since the incidence of cough in IV group was lower than that in group Ⅲ (P <0.05). Conclusion Sufentanil injection speed can influence the occurrence of cough response,and pre-implantation using dezocine can effectively reduce the different injection speed of sufentanil induced incidence of cough,effect in slow infusion group was obvious.So it is a good way to ensure stablity during anesthesia induction.
百度学术
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