Liu Xue-Sheng, Xu Guang-Hong, Shen Qi-Ying, Zhao Qing, Cheng Xin-Qi, Zhang Jian, Gu Er-Wei
Department of Anesthesiology, First Affiliated Hospital, Anhui Medical University, Anhui, China.
Department of Anesthesiology, First Affiliated Hospital, Anhui Medical University, Anhui, China.
Pharmacol Rep. 2015 Feb;67(1):52-5. doi: 10.1016/j.pharep.2014.08.004. Epub 2014 Aug 20.
Opioid-induced cough during induction of general anesthesia is a common phenomenon. Dezocine, a partial μ-receptors agonist and κ-receptors antagonist, has been documented effectively suppressing fentanyl-induced cough in general anesthesia induction. However, the effect of dezocine on sufentanil-induced cough is still unknown.
A total of 370 patients (American Society of Anesthesiologists physical status I-II), aged 18-70 years, undergoing elective surgery, were randomly divided into a control group (group C) and a dezocine group (group D) (n=185 in each group). Patients received dezocine 0.1mg/kg or an equal volume of 0.9% normal saline 2 min prior to intravenous sufentanil (0.5 μg/kg). The incidence and reflex degree of cough in patients were evaluated within 2 min after the injection of sufentanil in anesthesia induction period.
No patient in group D had cough and 59 patients in group C had cough (severity of cough: mild, 7%; moderate, 11.4%; severe, 13.5%). The occurrence and reflex degree of cough in group D was significantly lower than that in group C (P=0.000). The highest heart rate (HR) and invasive blood pressure (IBP) values were higher in group C than those in group D (P<0.01) within 2 min after sufentanil administration, althought these values remained within safe limits.
The results of current study suggest that administration of Dezocine 0.1mg/kg may effectively prevent the occurrence and reflex degree of sufentanil-induced irritating cough in general anesthesia induction in patients.
全身麻醉诱导期间阿片类药物引起的咳嗽是一种常见现象。地佐辛是一种μ受体部分激动剂和κ受体拮抗剂，已被证明能有效抑制全身麻醉诱导时芬太尼引起的咳嗽。然而，地佐辛对舒芬太尼引起咳嗽的作用仍不清楚。
总共370例年龄在18 - 70岁、美国麻醉医师协会身体状况分级为I - II级、接受择期手术的患者被随机分为对照组（C组）和地佐辛组（D组）（每组185例）。患者在静脉注射舒芬太尼（0.5μg/kg）前2分钟接受0.1mg/kg地佐辛或等体积的0.9%生理盐水。在麻醉诱导期注射舒芬太尼后2分钟内评估患者咳嗽的发生率和反射程度。
D组无患者咳嗽，C组有59例患者咳嗽（咳嗽严重程度：轻度，7%；中度，11.4%；重度，13.5%）。D组咳嗽的发生率和反射程度明显低于C组（P = 0.000）。舒芬太尼给药后2分钟内，C组的最高心率（HR）和有创血压（IBP）值高于D组（P < 0.01），尽管这些值仍在安全范围内。
本研究结果表明，给予0.1mg/kg地佐辛可有效预防患者全身麻醉诱导时舒芬太尼引起的刺激性咳嗽的发生和反射程度。
