摘要
目的研究静脉注射利多卡因对芬太尼诱导咳嗽反应的影响。方法择期行全麻手术病人60例，随机分为3组，组Ⅰ在芬太尼注射前1min静脉注射利多卡因1mg·kg^-1，组Ⅱ在芬太尼注射前1min静脉注射利多卡因2mg·kg^-1，组Ⅲ为对照组。分别观察芬太尼注射后的咳嗽反射情况，咳嗽1～2次为轻微，3～4次为中等，5次以上为重度。结果组Ⅰ、组Ⅱ、组Ⅲ三组咳嗽反应的发生率分别为25％，30％和60％，组Ⅰ、纽Ⅱ咳嗽反应的发生率明显低于组Ⅲ（P〈0．05），组Ⅰ、组Ⅱ之间咳嗽反应的发生率相近（P〉0．05）。结论芬太尼注射前1min静脉注射利多卡因1mg·kg^-1或2mg·kg^-1可以有效减轻芬太尼诱导的咳嗽反射。芬太尼注射前1min静脉注射利多卡因1mg·kg^-1或2mg·kg^-1对减轻芬太尼诱导的咳嗽反射区别不大。
Objective To evaluate the effectiveness of lidocaine for suppression of fentanyl - induced cough. Methods 60 cases ASA Ⅰ and Ⅱ patients were randomly allocated into three groups. The patients were assigned receive lidocaine 1 rag· kg^- 1（Group Ⅰ）, 2 mg· kg^- 1 （ Group Ⅱ）, or placebo （ Group Ⅲ） over five seconds, one minute before the administration of fentanyl 2 ptgg·kg^- 1 in a randomized and double - blind fashion. Any episode of cough was classified as coughing and graded as mild （ 1 - 2）, moderate （ 3 - 4） or severe （ 5 or more） . The data were ana- lyzed with the test of proportion. Results 5, 6 and 12 patients （25%, 30%, and 60% ） had cough in Groups Ⅰ, Ⅱ and Ⅱ respectively （P 〈 0.05 Groups Ⅰ, Ⅱ vs Ⅲ） . There was no significant difference in the incidence and severity of cough among the lidocaine pretreated groups Ⅰ and Ⅱ （ P 〉 0.05 ） . Conclusion The results of our study suggest that iv lidocaine 1 mg· kg^- 1 or 2 mg·kg^- 1 is effective to suppress fentanyl - induced cough when administered one minute prior to fentanyl. There was no significant difference in the incidence and severity of cough in the lidocaine pretreated groups.
