Department of Anesthesiology, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
J Anesth. 2013 Feb;27(1):25-8. doi: 10.1007/s00540-012-1470-y. Epub 2012 Aug 25.
We aimed to investigate the effects of pretreatment with a small dose of dexmedetomidine on the cough caused by sufentanil during anesthetic induction.
Two hundred and forty patients undergoing elective gynecological surgery under general anesthesia were randomly allocated to 4 groups (n = 60, each group). Dexmedetomidine 0, 0.1, 0.25, and 0.5 μg/kg was administered in 5 min to groups I, II, III, and IV, respectively, followed by the induction of general anesthesia with intravenous propofol, at a target concentration of 5 μg/ml, and sufentanil 0.5 μg/kg. The incidences and severity of cough that occurred within 1 min after the injection of sufentanil were recorded, and the incidences of cardiovascular adverse events that occurred between the administration of the dexmedetomidine infusion and 1 min after tracheal intubation were recorded.
The incidences of cough in group II, group III, and group IV were lower than that in group I (6.7, 5.0, and 6.7 vs. 26.7 %, P < 0.01), while there were no significant differences between group II, group III, and group IV. The incidences of severe sinus bradycardia in group III and group IV were higher than that in group I (18.3 and 23.3 vs. 0.0 %, P < 0.01), while there was no significant difference between group I and group II. There was no significant difference in the incidence of low blood pressure among the four groups.
Dexmedetomidine at 0.10, 0.25, and 0.50 μg/kg significantly reduced the incidence of sufentanil-induced cough during anesthetic induction, with the effect being most marked for 0.10 μg/kg dexmedetomidine.
本研究旨在探讨麻醉诱导前应用小剂量右美托咪定对舒芬太尼诱发咳嗽的影响。
选择 240 例行全身麻醉择期妇科手术的患者，随机分为 4 组（每组 60 例）。I、II、III 和 IV 组患者分别于 5 分钟内静脉注射右美托咪定 0、0.1、0.25 和 0.5μg/kg，然后以 5μg/ml 的目标浓度静脉注射异丙酚诱导全身麻醉，并给予舒芬太尼 0.5μg/kg。记录舒芬太尼注射后 1 分钟内咳嗽的发生情况和严重程度，以及右美托咪定输注至气管插管后 1 分钟内发生的心血管不良事件的发生率。
与 I 组相比，II 组、III 组和 IV 组咳嗽发生率较低（6.7%、5.0%和 6.7% vs. 26.7%，P < 0.01），而 II 组、III 组和 IV 组之间无显著差异。III 组和 IV 组严重窦性心动过缓的发生率高于 I 组（18.3%和 23.3% vs. 0.0%，P < 0.01），而 I 组和 II 组之间无显著差异。四组间低血压发生率无显著差异。
右美托咪定 0.10、0.25 和 0.50μg/kg 可显著降低麻醉诱导期间舒芬太尼诱发咳嗽的发生率，其中以 0.10μg/kg 右美托咪定的效果最为显著。
