Department of Anesthesiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
Department of Anesthesiology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China.
Drug Des Devel Ther. 2024 May 29;18:1865-1874. doi: 10.2147/DDDT.S462710. eCollection 2024.
This study was designed to investigate the effects of preadministration of nalmefene before general anesthesia induction on sufentanil-induced cough (SIC) in patients undergoing breast surgery.
A total of 105 patients scheduled for elective breast surgery under general anesthesia were selected and randomly assigned into three groups: normal saline (Group C), low-dose nalmefene 0.1 μg·kg (Group LN), and high-dose nalmefene 0.25 μg·kg (Group HN). Sufentanil 0.5 μg·kg was injected intravenously within 2 s after 5 min of intervention. The count and severity of cough within 2 min after sufentanil injection, as well as the time to first cough, were recorded. In addition, we also collected intraoperative hemodynamic data, postoperative pain scores, the incidence of receiving rescue analgesics, and side effects up to 24 h after surgery.
Compared to Group C, the incidence of SIC was significantly lower in Group LN and HN (64.7% vs 30.3% and 14.7%, respectively; < 0.001), but no significant difference was observed between the two groups (=0.126). Compared to Group C, the risk factors decreased by 53.4% (95% confidence interval [CI] =0.181-0.735, =0.008) in Group LN and by 75.9% (95% CI=0.432-0.898, =0.001) in Group HN. Of the patients with SIC, less frequent SIC within 2 min after induction and a lower proportion of severe coughs were observed than Group C ( < 0.05), and no difference was detected between Group LN and HN. Additionally, the onset time to the first SIC did not differ significantly between the groups. Intraoperative hemodynamic data, postoperative pain scores, and side effects in the first 24 h did not differ among the groups.
Preadministration of nalmefene prior to induction of general anesthesia effectively suppressed SIC in patients undergoing breast surgery, without affecting intraoperative hemodynamic fluctuation and postoperative pain intensity.
本研究旨在探讨全身麻醉诱导前给予纳美芬对接受舒芬太尼诱导性咳嗽（SIC）的乳腺手术患者的影响。
选择择期全身麻醉下接受乳腺手术的 105 例患者，随机分为三组：生理盐水组（C 组）、低剂量纳美芬 0.1μg·kg 组（LN 组）和高剂量纳美芬 0.25μg·kg 组（HN 组）。在干预后 5 分钟内，静脉注射舒芬太尼 0.5μg·kg，持续 2 秒。记录舒芬太尼注射后 2 分钟内咳嗽的次数和严重程度，以及首次咳嗽的时间。此外，还收集术中血流动力学数据、术后疼痛评分、术后 24 小时内接受解救性镇痛药物的发生率以及术后不良反应。
与 C 组相比，LN 组和 HN 组 SIC 的发生率显著降低（64.7%比 30.3%和 14.7%，均 < 0.001），但两组之间无显著差异（=0.126）。与 C 组相比，LN 组的危险因素降低了 53.4%（95%置信区间[CI]：0.181-0.735，=0.008），HN 组降低了 75.9%（95%CI：0.432-0.898，=0.001）。在出现 SIC 的患者中，与 C 组相比，诱导后 2 分钟内的 SIC 次数减少，严重咳嗽的比例降低（均 < 0.05），LN 组和 HN 组之间无差异。此外，三组之间首次 SIC 的发作时间无显著差异。各组的术中血流动力学数据、术后 24 小时内的疼痛评分和不良反应无差异。
全身麻醉诱导前给予纳美芬可有效抑制乳腺手术患者的 SIC，且不影响术中血流动力学波动和术后疼痛强度。
