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目的比较右美托咪定与地佐辛抑制芬太尼诱发咳嗽反射的效果。方法将择期手术患者80例,ASAⅠ或Ⅱ级,随机分为两组:右美托咪定组(Ⅰ组)和地佐辛组(Ⅱ组),每组40例。Ⅰ组静脉输注右美托咪定1μg/kg,Ⅱ组静脉注射地佐辛0.1 mg/kg,10 min后两组采用芬太尼4μg/kg、丙泊酚1.5 mg/kg、咪达唑仑0.05 mg/kg和维库溴铵0.1 mg/kg进行麻醉诱导,芬太尼静脉注射时间<2 s。记录芬太尼注射后2 min内发生咳嗽次数和咳嗽程度。记录麻醉前(T0)、右美托咪定静脉输注或地佐辛静脉注射10 min后(T1)、芬太尼快速静脉注射后2 min(T2)的心率(HR)、脉搏氧饱和度(SpO2)和平均动脉压(MAP)。记录T0～T2期间的镇静评分(OAA/S)。结果与Ⅰ组比较,Ⅱ组咳嗽的发生率明显降低(P<0.05),两组咳嗽程度比较差异无统计学意义。与Ⅰ组比较,Ⅱ组T1时心率减慢不明显(P<0.05)。两组OAA/S比较差异无统计学意义。结论右美托咪定和地佐辛都可以有效地抑制芬太尼诱发的咳嗽反射,但地佐辛应用的效果更好且更安全。
Objective To compare the effects of dexmedetomidine and dezocine on fentanyl-induced cough reflex. Methods Eighty ASA Ⅰ or Ⅱ patients undergoing elective surgery were randomly divided into two groups: dexmedetomidine group (group Ⅰ) and dezocine group (group Ⅱ), with 40 cases in each group. Group Ⅰ received dexmedetomidine 1 μg / kg intravenously, group Ⅱ received intravenous dezocine 0.1 mg / kg for 10 min, then received fentanyl 4 μg / kg, propofol 1.5 mg / kg, midazolam Lun 0.05 mg / kg and vecuronium 0.1 mg / kg for induction of anesthesia, intravenous infusion of fentanyl <2 s. The number of coughs and the degree of coughing within 2 min after the injection of fentanyl were recorded. The heart rate (HR), pulse oximetry (HR), blood pressure and blood pressure before anesthesia (T0), dexmedetomidine intravenous infusion or dezocine intravenous injection 10 min (T1), fentanyl 2 min (SpO2) and mean arterial pressure (MAP). Sedation scores (OAA / S) during T0-T2 were recorded. Results Compared with group Ⅰ, the incidence of cough in group Ⅱ was significantly lower than that in group Ⅰ (P <0.05). There was no significant difference in cough between the two groups. Compared with group Ⅰ, the heart rate of group Ⅱ did not slow down significantly at T1 (P <0.05). There was no significant difference between the two groups in OAA / S. Conclusion Both dexmedetomidine and dezocine can effectively inhibit fentanyl-induced cough reflexes, but dezocine is more effective and safer.