摘要
目的评价静脉注射硫酸镁对芬太尼诱发的咳嗽反应(FIC)的防治作用。方法 120名ASAⅠ～Ⅱ期拟行择期外科、妇科手术患者,随机分为M、L及S组,每组40名。M组、L组、S组分别静脉注射20mg/kg硫酸镁、1mg/kg利多卡因或5ml生理盐水。3min后静脉注射芬太尼3μg/kg,5s内完成注射。由一位对研究不知情的麻醉医生评估及记录静脉注射芬太尼后15s内FIC的发生率及其严重程度。记录各组患者给药前(T0)、给药后3min(T1)、麻醉诱导完成后(T2)、气管插管后1min(T3)、3min(T4)、5min(T5)时SBP、DBP、HR。结果 M组FIC发生率为5%,低于L组的25%、S组的80%(χ2=51.96),M组与L组相比(95%CI:-0.388～-0.012)、与S组相比(95%CI:-0.926～-0.574),FIC发生率有差异;M组FIC严重程度秩次为41.63,低于L组的52.48(t=1.84,P<0.05)、S组的87.40(t=7.76,P<0.05)。与S组相比,L组FIC严重程度较低(t=5.92,P<0.05)。各组患者的SBP、DBP、HR基本稳定。结论全麻诱导前3min静脉注射20mg/kg硫酸镁能有效抑制3μg/kg芬太尼诱发的咳嗽反应,效果优于1mg/kg利多卡因,且对血压、心率的影响轻微。
Objective To evaluate the effect of intravenous magnesium sulfate pretreatment on fentanyl - induced cough. Methods One hundred and twenty ASA Ⅰ- Ⅱpatients undergoing general anaesthesia were enrolled in this prospective, randomized, double - blind, placebo -controlled clinical trial. All patients were randomly assigned to one of three groups treated with intravenous magnesimn sulfate 20mg/kg（ group M,n=40）,lidocaine lmg/kg（group L,n=40）,or the same volume （5ml） of normal saline （group S,n =40）, respectively. Intravenous fentanyl （3 μg/kg in 5 s） was injected 3 min after the magnesium sulfate,lidocaine or normal saline injection. The occurrence and severity of cough were recorded for 15 s after fentanyl bolus by a blinded anesthesiologist. The severity of cough was graded as grade0（no cough）, grade 1 （thetime of cough duration ≤3s）,or grade2 （the time of cough duration 〉3s）. Changes in the physio- logic indicators such as heart rate （HR） , non -invasive blood pressure （NBP） were recorded before and 3 min after the magnesium sul- fate,lidoeaine or normal saline injection, after induction of anesthesia and I rain, 3rain, 5rain after endotracheal intubation, respectively. Results The incidence of fentanyl - induced cough was 5% , 25% and 80% in group M, group L and group S, respectively. Group M had alower incidence than group L（95%CI： -0.388- -0.012） and Group S（95%CI： -0.926- -0.574）,respectively. The rank of severity of fentanyl-induced cough in group M was 41.63,lower than 52.48 in group L（t=l.84,P〈0.05） and 87.40 in group S（t= 7.76 ,P 〈 0.05） ,respectively. There was no serious change in patients＇SBP, DBP, and HR for the duration of the trial among the three groups. Conclusion This study suggests that pretreatment with intravenous magnesium sulfate 20mg/kg could effectively reduce the inci- dence and severity of fentanyl - induced cough compared with lidocaine 1 mg/kg.
出处
《医学研究杂志》
2011年第12期69-72,共4页
Journal of Medical Research
