【摘要】 目的探讨不同剂量的利多卡因预防芬太尼诱导下咳嗽的效果,寻求预防咳嗽安全有效的临床剂量。方法选择200例全身麻醉患者.随机分为四组。组Ⅰ为对照组(0.9%氯化钠注射液10 ml),组Ⅱ为利多卡因1 mg/kg,组Ⅲ为利多卡因1.5 mg/kg,组Ⅳ为利多卡因2 mg/kg。试验药物经浅静脉10 s内注入后,观察患者1 min,记录利多卡因相关中毒症状,然后于5 s内静脉注射芬太尼3μg/kg,观察2 min,记录咳嗽的例数和强度。监测并记录诱导期各时段的收缩压、舒张压、心率和脉搏血氧饱和度。结果咳嗽发生率对照组为32%,组Ⅱ为8%,组Ⅲ为6%,组Ⅳ为8%,试验组与对照组相比均显著下降。随着利多卡因剂量增大,局部麻醉药中毒例数和症状有增加趋势,在气管插管后5、10 min组Ⅲ、Ⅳ的心率、收缩压、舒张压与气管插管后即刻的比较有显著性下降(P<0.05)。结论静脉注射利多卡因1～2 mg/kg能有效抑制芬太尼诱发的咳嗽;利多卡因1 mg/kg中毒反应轻,对循环影响较小,更适于临床使用。更多还原

【Abstract】 Objective To evaluate the effects of different doses of lidocaine on suppressing fentanyl-induced cough and determine a safe suppressing dose.Methods Two hundred patients undergoing general anesthesia were randomized to four groups evenly.The following medications were given within ten seconds:normal saline 10ml (groupⅠ,control group),lidocaine 1 mg/kg (groupⅡ),lidoeaine 1.5 mg/kg(groupⅢ),lidocaine 2mg/kg (groupⅣ).Toxic symptoms of lidocaine were recorded within lmin after the administration of lidocaine,then fentanyl 3μg/ kg was given intravenously within 5 seconds.Cough incidence and cough grade were recorded within 2rain after the administration of fentanyl.Systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rates (HR),and satu- ration of pulse oximeter(SpO2) were recorded during different time points of induction,all recorded data were anal- ysed by the statistical software,P value<0.05 was considered statistically significant.Results The incidence of cough was 32 % (16 cases) in groupⅠ,while the incidence of cough was significantly decreased in groupⅡ(8%), groupⅢ(6%) and groupⅣ(8%).The number of toxicated patients and severity of symptoms increased along with the increasing doses of lidocaine.The HR,SBP and DBP in 5rain and 10min time points after intubation were signifi- cantly decreased compared with those of the shortly after intubation(P<0.05).Conclusion Intravenous lidocaine 1～2mg/kg,are effective in suppressing fentanyl-induced cough.Ⅳlidocaine 1 mg/kg has less toxicity,less impact on circulation.It is a safer and more feasible dosage in clinical practice.更多还原