本文關(guān)鍵詞：鹽酸戊乙奎醚聯(lián)合深呼吸法抑制麻醉誘導(dǎo)時(shí)芬太尼誘發(fā)咳嗽反應(yīng)的有效性和安全性　出處：《中國現(xiàn)代醫(yī)學(xué)雜志》2017年18期 　論文類型：期刊論文

  更多相關(guān)文章： 鹽酸戊乙奎醚 深呼吸法 芬太尼誘發(fā)的咳嗽反應(yīng)

【摘要】：目的探討鹽酸戊乙奎醚(PHC)聯(lián)合深呼吸法抑制麻醉誘導(dǎo)時(shí)芬太尼誘發(fā)的咳嗽反應(yīng)(FIC)的有效性和安全性。方法選取2015年9月-2016年9月該院行手術(shù)治療的220例患者的臨床資料,隨機(jī)分為4組,每組55例。H組:于靜脈注射芬太尼前10 min給予PHC 0.01 mg/kg,用生理鹽水稀釋成10 ml靜脈注射。P組:芬太尼靜脈注射前,患者完成3次深呼吸后立刻靜脈注射芬太尼。M組:靜脈推注芬太尼前10 min給予PHC0.01 mg/kg用生理鹽水稀釋成10 ml靜脈注射,完成3次深呼吸后立即給予患者靜脈注射芬太尼。N組:按照一定誘導(dǎo)順序給予靜脈快速誘導(dǎo)。記錄患者靜脈注射芬太尼后2 min內(nèi)咳嗽出現(xiàn)的時(shí)間及嚴(yán)重程度,并計(jì)算咳嗽發(fā)生率;記錄靜脈注射芬太尼前10 min或靜脈注射PHC(T_0)、靜注芬太尼后1 min(T_1)、2 min(T2)的心率(HR)、收縮壓(SBP)、舒張壓(DBP)和脈搏血氧飽和度(SpO_2);并分別計(jì)算平均動(dòng)脈壓(MAP)。結(jié)果 4組患者咳嗽程度比較差異有統(tǒng)計(jì)學(xué)意義(χ~2=153.424,P=0.001);4組咳嗽發(fā)生時(shí)間比較差異有統(tǒng)計(jì)學(xué)意義(F=26.509,P=0.019)。4組患者FIC發(fā)生率差異有統(tǒng)計(jì)學(xué)意義(χ~2=12.488,P=0.006)。H組、P組、M組和N組FIC發(fā)生率分別為8例(14.5%)、7例(12.7%)、4例(7.3%)和17例(30.9%),將H組、P組和M組合并后,并與N組比較,差異有統(tǒng)計(jì)學(xué)意義(χ~2=11.337,P=0.001);4組患者HR、SpO_2及MAP在T_0、T_1和T_2時(shí)逐漸降低;T2時(shí)HR和MAP比T0時(shí)降低,差異有統(tǒng)計(jì)學(xué)意義(P0.5),T_0、T_1和T_2時(shí)間的SpO_2差異無統(tǒng)計(jì)學(xué)意義(P0.05)。4組不良反應(yīng)發(fā)生率及不良反應(yīng)比較無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 PHC聯(lián)合深呼吸法能有效抑制FIC的發(fā)生,優(yōu)于單獨(dú)使用PHC和深呼吸法,且對患者血流動(dòng)力學(xué)影響小,不良反應(yīng)少,安全性高。
[Abstract]:Objective to investigate the inhibition of fentanyl induced cough response (FICs) by pentehyclidine hydrochloride (PHCl) combined with deep breathing method in anesthetic induction. Methods the clinical data of 220 patients who underwent surgical treatment from September 2015 to September 2016 were selected. They were randomly divided into 4 groups, 55 cases in each group. Group H was given PHC 0. 01 mg/kg 10 min before intravenous injection of fentanyl. Group P was diluted with normal saline into 10 ml intravenous injection group: before fentanyl was injected intravenously. After three deep breaths, the patients in group M were injected with fentanyl immediately: 10 min before intravenous injection of fentanyl, PHC0.01 mg/kg was diluted into 10ml intravenous injection with normal saline. Immediately after 3 deep breaths, the patients were given intravenous fentanyl. N group: fast intravenous induction was given in a certain order. 2 fentanyl was recorded after intravenous fentanyl injection. The time and severity of cough in min. The incidence of cough was calculated. Heart rate was recorded 10 min before intravenous fentanyl injection or 1 min after intravenous injection of fentanyl. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse oxygen saturation (SPO _ 2); Results there were significant differences in cough degree among the 4 groups (蠂 ~ 2 153.424 P ~ (0.001)). There was significant difference in the occurrence time of cough among the 4 groups. There was significant difference in the incidence of FIC in the 4 groups (蠂 ~ 2 + 12.488). The incidence of FIC in P group (P group) and N group (P group) was 14.5 cases (n = 7) and 17 cases (n = 17). The difference between group H and group M was statistically significant compared with that of group N (蠂 2 + 11.337% P ~ (0.001)). HRO _ 2 and MAP in the four groups decreased gradually at the time of T0 / T _ (1) and T _ (2). HR and MAP at T2 were lower than those at T0, and the difference was statistically significant. There was no significant difference in SpO_2 between T _ 1 and T _ 2. There was no significant difference in the incidence of adverse reactions and adverse reactions in P0.05.4 group (P 0.05). Conclusion PHC combined with deep breathing can effectively inhibit the occurrence of FIC. It is superior to PHC and deep breathing alone, and has less hemodynamic effect, fewer adverse reactions and higher safety.
【作者單位】： 湖南省婦幼保健院麻醉科;
【分類號】：R614
【正文快照】： 芬太尼是臨床麻醉中使用最多的藥物,其起效快,鎮(zhèn)痛效果強(qiáng),作用時(shí)間短,心血管系統(tǒng)影響小[1]。麻醉誘導(dǎo)前靜脈注射芬太尼后,�？梢姺姨嵴T發(fā)的咳嗽反應(yīng)(fentanyl-induced cough,FIC)[2]。FIC發(fā)病率為18%~65%,常表現(xiàn)為短暫的、爆發(fā)性咳嗽[3]。FIC一旦爆發(fā)需要立即終止,有報(bào)道稱，

本文編號：1431281