比较不同剂量羟考酮预防全麻诱导期芬太尼诱发咳嗽的效果。
Comparing the different oxycodone doses of prevent oxycodone for prevention of preventing fentanyl-induced cough during induction of general anaesthesia.
机构信息
Department of Anesthesiology, The Affiliated Xuzhou No. 1 People's Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Department of Anesthesiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
出版信息
Int J Clin Pract. 2020 Dec;74(12):e13642. doi: 10.1111/ijcp.13642. Epub 2020 Aug 14.
BACKGROUND
Fentanyl-induced cough (FIC) usually occurs after the intravenous administration of fentanyl during general anaesthesia induction. It is a transient condition depending on the fentanyl administration dose and injection speed. Oxycodone can also prevent FIC because it has been proven to treat coughing. This study aimed to evaluate the efficacy of different oxycodone doses to prevent FIC during general anaesthesia induction.
METHODS
In a double-blind randomised controlled trial, 210 adult patients who were undergoing elective surgery, classified as American Society of Anaesthesiologists physical status I-II, and aged 20-65 years were randomly assigned into five equally sized groups: Sham group, Group Ⅰ, Group II, Group III and Group IV. Groups Ⅰ-IV were each intravenously injected with oxycodone 0.025, 0.05, 0.075 and 0.100 mg/kg, while an equal volume of normal saline was given instead of oxycodone in the Sham group. Five minutes later, fentanyl 3 μg/kg was intravenously injected within 5 seconds, then, 2 minutes later the other drugs were administered for general anaesthesia induction. The occurrence and severity of coughing were observed within 2 minutes of the fentanyl injection. Vital signs and intensities of coughing were recorded and analysed.
RESULTS
Coughing incidences were each 57.1, 50, 42.8, 33.3 and 21.4% in the Sham group and Groups Ⅰ-IV. Significant differences were found in the incidences of coughing between the Sham group and Groups III-IV. No significant differences in FIC incidences have been detected between the Sham group and Groups Ⅰ-II. However, no significant difference in FIC incidence existed between Group III and Group IV. Cough severities in Groups III and IV were significantly lower than in Groups Ⅰ and II (P < .05). No significant differences existed in the hypotension or severe bradycardia incidences during anaesthesia induction among the five groups (P > .05).
CONCLUSION
Oxycodone 0.075 mg/kg provided more effective FIC prevention during general anaesthesia induction.
背景
芬太尼诱导咳嗽（FIC）通常发生在全身麻醉诱导期间静脉注射芬太尼后。它是一种短暂的状态，取决于芬太尼的给药剂量和注射速度。羟考酮也可以预防 FIC，因为它已被证明可以治疗咳嗽。本研究旨在评估不同剂量羟考酮预防全身麻醉诱导期间 FIC 的效果。
方法
在一项双盲随机对照试验中，将 210 名接受择期手术的成年患者（美国麻醉医师协会身体状况 I-II 级），年龄 20-65 岁，随机分为五组，每组 42 人：假手术组、Ⅰ组、Ⅱ组、Ⅲ组和Ⅳ组。Ⅰ-Ⅳ组患者分别静脉注射羟考酮 0.025、0.05、0.075 和 0.100mg/kg，而假手术组则给予等体积的生理盐水代替羟考酮。5 分钟后，5 秒内静脉注射芬太尼 3μg/kg，2 分钟后给予其他药物进行全身麻醉诱导。观察芬太尼注射后 2 分钟内咳嗽的发生和严重程度。记录并分析生命体征和咳嗽强度。
结果
假手术组和Ⅰ-Ⅳ组的咳嗽发生率分别为 57.1%、50%、42.8%、33.3%和 21.4%。假手术组与Ⅲ-Ⅳ组之间的咳嗽发生率存在显著差异。假手术组与Ⅰ-Ⅱ组之间的 FIC 发生率无显著差异。然而，Ⅲ组与Ⅳ组之间的 FIC 发生率无显著差异。Ⅲ组和Ⅳ组的咳嗽严重程度明显低于Ⅰ组和Ⅱ组（P<0.05）。五组患者麻醉诱导期间低血压或严重心动过缓的发生率无显著差异（P>0.05）。
结论
全身麻醉诱导时，羟考酮 0.075mg/kg 可更有效地预防 FIC。
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