舒芬太尼不同给药方式全麻诱导对患者呛咳的影响.docxVIP

舒芬太尼不同给药方式全麻诱导对患者呛咳的影响 　　[摘要]目的探讨舒芬太尼不同给药方式全麻诱导对患者呛咳的影响。方法将2018年1月～2019年6月在我院行全身麻醉气管插管择期手术的90例患者依据舒芬太尼不同给药模式随机分为三组，麻醉诱导使用舒芬太尼（0.3～0.5）μg/kg，a组30例一次性推完，b组30例半剂量分次推注间隔1min，c组30例1/3剂量分3次推注，肌松药物作用完全后行气管插管，对比三组的呛咳发生时间、发生率及严重程度，记录呛咳发生前后的血压、心率、血氧饱和度变化。结果a组、b组呛咳发生时间明显短于c组，呛咳发生率及严重程度均高于c组（p0.05）;三组在麻醉诱导前（t1）、麻醉诱导后（t2）、气管插管前（t3）、气管插管后（t4）的hr、map、spo2水平无明显差异（p0.05）。结论舒芬太尼采用1/3剂量3次推注的给药模式对呛咳的抑制效果最好，能有效降低呛咳发生率及严重程度，且对血流动力学无明显不良影响。 　　[关键词]舒芬太尼;不同给药模式;全麻诱导;呛咳 　　[中图分类号]r614[文献标识码]b[文章编号]1673-9701（2020）10-0145-03 　　[abstract]objectivetoinvestigateimpactsofdifferenttypesofsufentaniladministrationasinductionofgeneralanesthesiaoncoughreflex.methodsninetypatientsreceivinggeneralanesthesiawithendotrachealintubationforsurgeryfromjanuary2018tojune2019weredividedintothreegroupsaccordingtodifferenttypesofsufentaniladministration.sufentanilasintroductionofanesthesiawasadministeredatthedoseof（0.3-0.5）μg/kginallgroups.patientsingroupa（n=30）wereinjectedoncewithfulldoseofsufentanil，whileingroupb（n=30）wereinjectedtwicewithhalfdoseeachtime.theintervalbetweenthetwoinjectionswas1min.subjectsingroupc（n=30）wereadministeredthreetimeswith1/3doseeachtime.asamusclerelaxantcompletelyexerteditsrelaxanteffects，endotrachealintubationwasconducted.thedurationofcough，incidencerates，degree，andbaselineandpost-coughmeanarterialbloodpressure（map），heartrate（hr）andarterialoxygensaturation（spo2）wererecordedandcomparedbetweenthethreegroups.resultsthedurationofcoughingroupaandgroupbwassignificantlyshorterthanthatingroupcandtheincidenceandseverityofcoughwerehigherthanthatingroupc（p0.05）.therewerenosignificantdifferencesinhr，mapandspo2amongthethreegroupsbefore（t1）andafterinductionofgeneralanesthesia（t2）andbefore（t3）orafterendotrachealintubation（t4）（p0.05）.conclusionsufentaniladministrationforthreetimeswith1/3doseeachtimeshowedsuperiorinhibitoryeffectsoncoughreflexoverothertwotypesofdelivery.itsignificantlyreducedincidenceratesanddegreeofcoughwithoutsignificanthaemodynamicresponses. 　　[keywords]sufentanil