比较利多卡因、呼吸急促动作和两者联合预防麻醉诱导前芬太尼引起的咳嗽：一项双盲、前瞻性、随机安慰剂对照研究。

Comparison of lidocaine, huffing maneuver and combination of both in prevention fentanyl induced cough before induction of anesthesia: a double-blind, prospective, randomized placebo-controlled study.

机构信息

Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

BMC Anesthesiol. 2021 Mar 27;21(1):92. doi: 10.1186/s12871-021-01313-w.

DOI:10.1186/s12871-021-01313-w

PMID:33773577

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7997790/

Abstract

BACKGROUND

Intravenous bolus injection of fentanyl has been frequently reported to be associated with cough reflex during patient anesthesia. However, the search for the most effective protocol continues. This study aimed to compare the effect of reducing cough reflex after injection of fentanyl in a fusion protocol by combining the injections of lidocaine and Huffing maneuver and comparing with a placebo control group, before anesthesia induction.

METHODS

This prospective randomized controlled trial study was performed on 400 patients who were divided into four groups of combined protocol (group 1), lidocaine group (group 2), Huffing maneuver group (group 3), and the control receiving normal saline (group 4). Then patients were injected with 2. 5 μg /kg fentanyl and monitored for 2 min regarding their cough reflex, as well as the severity.

RESULTS

In group one, 9 patients (9%), in group two, 45 patients (45%), 22 patients (22%) in group three, and in group four, 75 patients (75%), developed cough reflex following fentanyl injection. Also, 13 patients (13%) developed moderate and 4 (4%) developed severe coughs in the control group reported, while no reports of severe or moderate cough were among the intervention groups. There was a significant difference between the intervention group and the control group both in terms of the rate and severity of the fentanyl-induced cough.

CONCLUSION

By using a combination of lidocaine injection along and Huffing maneuver, better results can be obtained in reducing the frequency, and also the severity of cough followed by fentanyl injection.

TRIAL REGISTRATION

The trial was registered with IRCT.IR (09/03/2018-No. IRCT20141009019470N74 ).

摘要

背景

静脉推注芬太尼在患者麻醉期间常引起咳嗽反射。然而，人们仍在寻找最有效的方案。本研究旨在比较在麻醉诱导前通过联合应用利多卡因注射和 Huffing 手法，以及与安慰剂对照组融合方案减少芬太尼注射后咳嗽反射的效果。

方法

这是一项前瞻性随机对照试验研究，共纳入 400 例患者，分为联合方案组（第 1 组）、利多卡因组（第 2 组）、Huffing 手法组（第 3 组）和接受生理盐水的对照组（第 4 组）。然后，每组患者均注射 2.5μg/kg 的芬太尼，并监测 2 分钟内的咳嗽反射及其严重程度。

结果

第 1 组有 9 例（9%）、第 2 组有 45 例（45%）、第 3 组有 22 例（22%）和第 4 组有 75 例（75%）患者在注射芬太尼后出现咳嗽反射。对照组报告有 13 例（13%）出现中度咳嗽和 4 例（4%）出现重度咳嗽，而干预组中未报告重度或中度咳嗽。干预组与对照组在芬太尼引起的咳嗽的发生率和严重程度方面均存在显著差异。