【摘要】 目的观察纳美芬对全麻诱导时舒芬太尼诱发呛咳、术中丙泊酚用量以及术后镇痛效果的影响。方法选取拟行乳腺癌根治术的全麻患者300例,年龄18~60岁,BMI 18~30kg/m~2,ASAⅠ—Ⅲ级,根据随机数字表法将患者随机分为4组,每组75例:C组(生理盐水)、L组(利多卡因1mg/kg),N1组(纳美芬0.1μg/kg)和N2组(纳美芬0.2μg/kg)。各组分别给予相应的药物2min后开始全麻诱导:靶控输注丙泊酚3.5μg/ml、静推舒芬太尼0.3μg/kg(时间5s)2min后,静推罗库溴铵0.6mg/kg,90s后插管。术毕静注氟比洛芬酯50mg镇痛。记录呛咳发生率及严重程度,记录术中丙泊酚用量,记录术毕、术后6h及24h的VAS疼痛评分。结果 C、L、N1及N2组患者呛咳发生率分别为37.3%、21.3%、5.3%及1.3%。N1组和N2组呛咳发生率明显低于C组和L组(P<0.01或P<0.05),N1组和N2组差异无统计学意义。C、L组术中丙泊酚用量明显少于N2组(P<0.05)。四组术后VAS疼痛评分差异无统计学意义。结论纳美芬0.1μg/kg可有效预防全麻诱导时舒芬太尼引起的呛咳,且不影响术中丙泊酚用量及术后的镇痛效果。更多还原

【Abstract】 Objective To observe the effect of nalmefene on preventing sufentanil-induced cough during induction of general anesthesia,and its effect on the intraoperative propofoldosage and postoperative analgesia.Methods A total of 300 breast cancer patients undergoing radical mastectomy under general anesthesia,aged 18-60 years,BMI 18-30 kg/m~2,ASA physical statusⅠ-Ⅲ,were randomly divided into 4 groups(n = 75):group C(physiological saline),group L(lidocaine 1 mg/kg),group N1(nalmefene 0.1μg/kg)and group N2(nalmefene 0.2μg/kg).Two minites after giving the corresponding drug for each group,general anesthesia was induced according to the following:TCI propofol(3.5μg/ml)and intravenous injection of 0.3μg/kg sufentanil within5 seconds,0.6 mg/kg rocuronium was intravenously injected,90 seconds later,intubation was performed.The incidence and severity of cough and intraoperative dosage of propofol were recorded.The pain VAS scores at 0 h,6 hand 24 hafter operation were recorded.Results The incidence of cough in groups C,L,N1 and N2 was 37.3%,21.3%,5.3% and 1.3%,respectively.The incidence of cough in group N1 was significantly lower than that of group C and group L(P < 0.01 or P <0.05).There was no difference in preventing sufentanil-induced cough between group N1 and group N2.Compared with groups C and L,the intraoperative dosage of propofol was greater in group N2(P < 0.05).There was no difference in postoperative pain VAS scores between the four groups.Conclusion Nalmefene 0.1μg/kg can prevent sufentanil-induced cough during induction without affecting intraoperative propofol dosage and postoperative analgesia.更多还原