CAJ | 학술논문

目的比较右美托咪定与利多卡因抑制芬太尼诱发全麻诱导期患者呛咳反应的效果.方法择期妇科手术患者200例,ASA分级Ⅰ或Ⅱ级,年龄36 ～ 50岁,均采用全凭静脉麻醉,采用随机数字表法,将其分为2组(n=100):右美托咪定组(D组)和利多卡因组(L组).D组于麻醉诱导前20min静脉输注右美托咪定0.5 μg/kg,输注速率0.05 μg·kg-1· min-1,L组于麻醉诱导前1 min缓慢静脉注射利多卡因0.5 mg/kg.麻醉诱导最先使用芬太尼,2 min后给予其他诱导药物,记录注射芬太尼后1 min内呛咳反应的发生情况及程度.记录观察期内不良事件的发生情况.结果与D组比较,L组呛咳反应发生率升高,呛咳程度严重(P＜0.05).两组低血压和严重窦性心动过缓的发生率比较差异无统计学意义(P＞0.05).结论麻醉诱导前静脉注射右美托咪定0.5 μg/kg抑制芬太尼诱发全麻诱导期患者呛咳反应的效果优于利多卡因0.5 mg/kg.
목적 비교우미탁미정여리다잡인억제분태니유발전마유도기환자창해반응적효과.방법 택기부과수술환자200례,ASA분급Ⅰ혹Ⅱ급,년령36 ～ 50세,균채용전빙정맥마취,채용수궤수자표법,장기분위2조(n=100):우미탁미정조(D조)화리다잡인조(L조).D조우마취유도전20min정맥수주우미탁미정0.5 μg/kg,수주속솔0.05 μg·kg-1· min-1,L조우마취유도전1 min완만정맥주사리다잡인0.5 mg/kg.마취유도최선사용분태니,2 min후급여기타유도약물,기록주사분태니후1 min내창해반응적발생정황급정도.기록관찰기내불량사건적발생정황.결과 여D조비교,L조창해반응발생솔승고,창해정도엄중(P＜0.05).량조저혈압화엄중두성심동과완적발생솔비교차이무통계학의의(P＞0.05).결론 마취유도전정맥주사우미탁미정0.5 μg/kg억제분태니유발전마유도기환자창해반응적효과우우리다잡인0.5 mg/kg.
Objective To compare dexmedetomidine versus lidocaine for suppression of fentanyl-induced coughing during induction of general anesthesia in patients.Methods Two hundred ASA physical status Ⅰ or Ⅱ patients,aged 36-50 yr,undergoing elective gynecological operations under total intravenous anesthesia,were randomized into 2 groups (n =100 each):dexmedetomidine group (group D) and lidocaine group (group L).Dexmedetomidine 0.5 μg/kg was intravenously infused over 10 min at a rate of 0.05 μg· kg-1· min-1 starting from 20 min before induction of anesthesia in group D.Lidocaine 0.5 mg/kg was injected intravenously at 1 min before induction of anesthesia in group L.For induction of anesthesia,fentanyl was given first,and 2 min later the other drugs were given.The development and degree of coughing were recorded within 1 min after fentanyl injection.The occurrence of adverse events was recorded.Results The incidence of coughing was significantly higher and the degree of coughing was severer in group L than in group D (P ＜ 0.05).There was no signihicant difference in the incidences of hypotension and severe sinus bradycardia between groups D and L (P ＞ 0.05).Conclusion Dexmedetomidine 0.5 μg/kg injected before induction of anesthesia has better suppressive effect on fentanyl-induced coughing during induction of general anesthesia than lidocaine 0.5 mg/kg in patients.