Department of Anesthesiology, Lishui People's Hospital, Lishui, 323000, People's Republic of China.
Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China.
Drug Des Devel Ther. 2024 May 17;18:1603-1612. doi: 10.2147/DDDT.S464823. eCollection 2024.
Cough is one of the most common complications following intravenous administration of sufentanil during anesthesia induction. The study aimed to investigate the protective effect of alfentanil, afentanyl derivative with short onset time and short duration, in reducing sufentanil-induced cough.
Eighty patients that scheduled for thyroid surgery under general anesthesia were randomly divided into the alfentanil group and normal saline group, with 40 cases per group. Patients in the alfentanil group received intravenous administration of 2 μg/kg alfentanil prior to sufentanil injection during general anesthesia induction, while the same dose of normal saline was administered in the normal saline group. The outcomes measures included the incidence and severity of cough and common side effects of opioids following the administration of sufentanil during the induction of general anesthesia, intraoperative hemodynamics parameters and major adverse events during anesthesia recovery period.
The incidence of cough within one minute after the injection of sufentanil during anesthesia induction was 40% in the normal saline group, and the pretreatment of alfentanil significantly reduced the incidence of sufentanil-induced cough to 5% (p < 0.05). Correspondingly, the patients in the alfentanil group had decreased severity of sufentanil-induced cough compared with the normal saline group (p < 0.05). No significant differences in the incidences of common side effects of opioids (dizziness, nausea and vomiting, chest tightness and respiratory depression) within one minute after sufentanil injection were found (p > 0.05). Furthermore, there were no significant differences between the two groups in intraoperative hemodynamic parameters, extubation time, or the incidences of emergence agitation, respiratory depression, delayed recovery from anesthesia and postoperative nausea and vomiting during Postanesthesia Care Unit stay (p > 0.05).
Pretreatment with low-dose alfentanil (2 μg/kg) effectively and safely reduced both the incidence and severity of sufentanil-induced cough during anesthesia induction.
Chinese Clinical Trial Registry (identifier: ChiCTR2300069286).
静脉注射舒芬太尼诱导麻醉后，咳嗽是最常见的并发症之一。本研究旨在探讨阿芬太尼（一种起效时间短、作用时间短的阿芬太尼衍生物）对减少舒芬太尼诱导性咳嗽的保护作用。
80 例行全身麻醉甲状腺手术的患者被随机分为阿芬太尼组和生理盐水组，每组 40 例。阿芬太尼组患者在全身麻醉诱导期间静脉注射舒芬太尼前给予 2μg/kg 阿芬太尼，生理盐水组患者给予相同剂量的生理盐水。观察指标包括全身麻醉诱导期间舒芬太尼注射后咳嗽的发生率和严重程度、术中血流动力学参数以及麻醉恢复期的主要不良事件。
生理盐水组患者在麻醉诱导期间舒芬太尼注射后 1 分钟内咳嗽的发生率为 40%，而阿芬太尼预处理可显著降低舒芬太尼诱导性咳嗽的发生率至 5%（p<0.05）。相应地，阿芬太尼组患者的舒芬太尼诱导性咳嗽严重程度较生理盐水组患者降低（p<0.05）。舒芬太尼注射后 1 分钟内，两组患者常见阿片类药物不良反应（头晕、恶心呕吐、胸闷和呼吸抑制）的发生率无显著差异（p>0.05）。此外，两组患者术中血流动力学参数、拔管时间、术后麻醉恢复室出现激越、呼吸抑制、麻醉恢复延迟以及恶心呕吐的发生率无显著差异（p>0.05）。
低剂量阿芬太尼（2μg/kg）预处理可有效且安全地降低麻醉诱导期间舒芬太尼诱导性咳嗽的发生率和严重程度。
中国临床试验注册中心（注册号：ChiCTR2300069286）。
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