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地佐辛、利多卡因、麻黄碱对芬太尼呛咳反应抑制作用的比较

王志,  董源洪,  陈振毅

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文章导航 > 药学实践与服务  > 2016 >  34(5): 463-465
王志, 董源洪, 陈振毅. 地佐辛、利多卡因、麻黄碱对芬太尼呛咳反应抑制作用的比较[J]. 药学实践与服务, 2016, 34(5): 463-465. doi: 10.3969/j.issn.1006-0111.2016.05.021
引用本文: 王志, 董源洪, 陈振毅. 地佐辛、利多卡因、麻黄碱对芬太尼呛咳反应抑制作用的比较[J]. 药学实践与服务, 2016, 34(5): 463-465. doi: 10.3969/j.issn.1006-0111.2016.05.021
shu
WANG Zhi, DONG Yuanhong, CHEN Zhenyi. Comparison of the suppressive effect of dezocine,lidocaine and ephedrine on fentanyl-induced cough[J]. Journal of Pharmaceutical Practice and Service, 2016, 34(5): 463-465. doi: 10.3969/j.issn.1006-0111.2016.05.021
Citation: WANG Zhi, DONG Yuanhong, CHEN Zhenyi. Comparison of the suppressive effect of dezocine,lidocaine and ephedrine on fentanyl-induced cough[J]. Journal of Pharmaceutical Practice and Service, 2016, 34(5): 463-465. doi: 10.3969/j.issn.1006-0111.2016.05.021
shu

地佐辛、利多卡因、麻黄碱对芬太尼呛咳反应抑制作用的比较

doi: 10.3969/j.issn.1006-0111.2016.05.021

  • 厦门大学附属第一医院麻醉科, 福建 厦门 361003

Comparison of the suppressive effect of dezocine,lidocaine and ephedrine on fentanyl-induced cough

  • Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, China

  • 摘要: 目的 评价地佐辛、利多卡因及麻黄碱抑制芬太尼呛咳反应的作用。 方法 选择120例美国麻醉医师协会（ASA，American Society of Anesthesiologists）分级为Ⅰ~Ⅱ级择期行全麻手术的患者，随机均分为4组。Ⅰ、Ⅱ、Ⅲ、Ⅳ组分别给予生理盐水（2 ml）、地佐辛（0.1 mg/kg）、利多卡因（1 mg/kg）、麻黄碱（5 mg），1 min后各组均由外周静脉给予芬太尼4 μg/kg，再1 min后各组均给予咪达唑仑（0.1 mg/kg）+丙泊酚（2 mg/kg，0.4 ml/s）+顺阿曲库铵（0.2 mg/kg）。观察呛咳的发生率和强度、诱导前后血流动力学的变化。 结果 各组呛咳的发生率分别为：Ⅰ组50%、Ⅱ组16.7%、Ⅲ组13.3%、Ⅳ组20%，与Ⅰ组相比，Ⅱ、Ⅲ、Ⅳ组呛咳的发生率均有显著降低（P<0.05），但3个实验组间呛咳的发生率及强度并无显著性差异。各组诱导前后血流动力学的变化一致。 结论 预注射地佐辛（0.1 mg/kg）、利多卡因（1 mg/kg）或麻黄碱（5 mg）均能有效地减轻芬太尼引发的呛咳反应。
    Abstract: Objective To evaluate the suppressive effect of dezocine, lidocaine and ephedrine on fentanyl-induced cough. Methods A total of 120 patients ASA I-II, scheduled for elective surgery under general anesthesia, were randomly allocated into four groups (n=30, each group). Group Ⅰ,Ⅱ,Ⅲ, Ⅳ were given saline (2 ml), dezocine (0.1 mg/kg), lidocaine(1 mg/kg) or ephedrine(5 mg), respectively. One minute later all patients were injected with 4 μg/kg of fentanyl, after another one minute, all patients were given midazolam(0.1 mg/kg)+ propofol(2 mg/kg,0.4 ml/s)+cisatracurium (0.2 mg/kg). The incidence rate and severity of cough were recorded and hemodynamic parameters were also observed. Results The incidence rate of cough was 50%, 16.7%, 13.3% and 20% for group Ⅰ,Ⅱ,Ⅲ and Ⅳ, respectively. Comparing to group I, the incidence rate of cough was significantly lower (P<0.05) in other groups, but among the three experimental groups there was no significant difference in cough incidence rate and intensity. The hemodynamic changed of each group before and after the induction was consistent. Conclusion A priming dose of dezocine(0.1 mg/kg), lidocaine (1 mg/kg) or ephedrine (5 mg) could effectively reduce the Fentanyl-induced cough response.
  • [1] Agarwal A, Azim A, Ambesh S, et al. Salbutamol, beclomethasone or sodium chromoglycate suppress coughing induced by iv fentanyl [J]. Can J Anesth, 2003,50(3) : 297-300.
    [2] Lin CS, Sun WZ, Chan WH, et al. Intravenous lidocaine and ephedrine, but not propofol, suppress fentanyl-induced cough [J]. Can J Anaesth, 2004, 51 (7) :654- 659.
    [3] Pandey CK, Raza M, Ranjan R, et al. Intravenous lidocaine 0.5 mg·kg-1 effectively suppresses fentanyl-induced cough [J]. Can J Anaesth, 2005, 52(2) :172- 175.
    [4] Sun ZT,Yang CY,Zhang J,et al.Effect of intravenous dezocine on fentanyl-induced cough during general anesthesia inducition:a double-blinded, prospective,randomized,controlled trial [J].J Anesth,2011,25 (6):860-863.
    [5] Tweed WA,Dakin D.Explosive coughing after bolus fentanyl injection[J].Anesth Analg,2001,92(6):1442-1443.
    [6] Lou YP.Regulation of neuropeptide release from pulmonary capsaicin-sensitive aferents in relation to bronchoconstriction [J].Acta Physiol Scand,1993,612:1-88.
    [7] Tanaka M,Maruyama K. Mechanisms of capsaicin- and citric-acid-induced cough reflexes in gunnea pigs [J].J Pharm Sci,2005,99 (1):77-82.
    [8] Ai Q,Hu Y,Wang Y, et a1. Pentazocine pretreatment suppresses fentanyl -induced cough [J]. Pharmacol Rep,2010,62 (4):747-750.
    [9] Hung KC.The possible mechanism of clonidie to suppress fentanyl-induced coughing[J].Acta Anaesthesiol Scand, 2009,53 (9): 1227-1228.
    [10] Karlsson JA,Lanner AS,Persson CG.Airway opioid receptors mediate inhibition of cough and reflex bronchoconstriction in guinea pigs[J].J Pharmacol Exper Therap,1990,252 (2):863.
    [11] 卞清明,顾连兵,高 蓉,等.预先静脉注射地佐辛对芬太尼诱发咳嗽反射的影响[J].临床麻醉学杂志,2012,28 (8):770.
    [12] Xu YJ,Zhu Y, Wang SL,et al.Dezocine attenuates fentanyl-induced cough in a dose-dependent manner-a randomized controlled trial [ J ].Int J Clin Eexp Med,2015,8(4):6091-6096.
    [13] EL Baissari MC,Taha SK,Siddik-Sayyid SM,et al. Fentanyl-induced cough-pathophysiology and prevention[J]. Middle East J Anesthesiol, 2014,22(5):449-456.
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  • 收稿日期:  2015-10-07
  • 修回日期:  2016-05-03

地佐辛、利多卡因、麻黄碱对芬太尼呛咳反应抑制作用的比较

doi: 10.3969/j.issn.1006-0111.2016.05.021
  • 厦门大学附属第一医院麻醉科, 福建 厦门 361003
  • 收稿日期: 2015-10-07
  • 修回日期: 2016-05-03

摘要: 目的 评价地佐辛、利多卡因及麻黄碱抑制芬太尼呛咳反应的作用。 方法 选择120例美国麻醉医师协会（ASA，American Society of Anesthesiologists）分级为Ⅰ~Ⅱ级择期行全麻手术的患者，随机均分为4组。Ⅰ、Ⅱ、Ⅲ、Ⅳ组分别给予生理盐水（2 ml）、地佐辛（0.1 mg/kg）、利多卡因（1 mg/kg）、麻黄碱（5 mg），1 min后各组均由外周静脉给予芬太尼4 μg/kg，再1 min后各组均给予咪达唑仑（0.1 mg/kg）+丙泊酚（2 mg/kg，0.4 ml/s）+顺阿曲库铵（0.2 mg/kg）。观察呛咳的发生率和强度、诱导前后血流动力学的变化。 结果 各组呛咳的发生率分别为：Ⅰ组50%、Ⅱ组16.7%、Ⅲ组13.3%、Ⅳ组20%，与Ⅰ组相比，Ⅱ、Ⅲ、Ⅳ组呛咳的发生率均有显著降低（P<0.05），但3个实验组间呛咳的发生率及强度并无显著性差异。各组诱导前后血流动力学的变化一致。 结论 预注射地佐辛（0.1 mg/kg）、利多卡因（1 mg/kg）或麻黄碱（5 mg）均能有效地减轻芬太尼引发的呛咳反应。

English Abstract

王志, 董源洪, 陈振毅. 地佐辛、利多卡因、麻黄碱对芬太尼呛咳反应抑制作用的比较[J]. 药学实践与服务, 2016, 34(5): 463-465. doi: 10.3969/j.issn.1006-0111.2016.05.021
引用本文: 王志, 董源洪, 陈振毅. 地佐辛、利多卡因、麻黄碱对芬太尼呛咳反应抑制作用的比较[J]. 药学实践与服务, 2016, 34(5): 463-465. doi: 10.3969/j.issn.1006-0111.2016.05.021
shu
WANG Zhi, DONG Yuanhong, CHEN Zhenyi. Comparison of the suppressive effect of dezocine,lidocaine and ephedrine on fentanyl-induced cough[J]. Journal of Pharmaceutical Practice and Service, 2016, 34(5): 463-465. doi: 10.3969/j.issn.1006-0111.2016.05.021
Citation: WANG Zhi, DONG Yuanhong, CHEN Zhenyi. Comparison of the suppressive effect of dezocine,lidocaine and ephedrine on fentanyl-induced cough[J]. Journal of Pharmaceutical Practice and Service, 2016, 34(5): 463-465. doi: 10.3969/j.issn.1006-0111.2016.05.021
shu

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