静脉注射利多卡因预防芬太尼诱发呛咳的临床研究

目的探讨静脉注射不同剂量的利多卡因预防芬太尼诱导引起呛咳的效果。方法选择200例择期全麻手术病人,ASA分级Ⅰ-Ⅱ级,随机分层分为四组：Ⅰ组为对照组,静脉注射生理盐水10ml,Ⅱ组为利多卡因0.5 mg/kg,Ⅲ组为利多卡因1.0 mg/kg,Ⅳ组为利多卡因1.5 mg/kg,所有利多卡因组加生理盐水至10ml。实验药物经上肢静脉10s内注入,2min后静脉注射芬太尼3μg/kg（注射时间5s）,观察5min,记录呛咳的例数和强度。结果呛咳发生率Ⅰ组为40%（20/50）,Ⅱ组为16%（8/50）,Ⅲ组为14%（7/50）,组Ⅳ为14%（7/50）,三个实验组与对照组相比均显著下降;三个实验组之间呛咳发生率无统计学意义。结论静脉注射利多卡因能有效抑制芬太尼诱发的呛咳,其最佳剂量为0.5mg/kg。

Clinical study on intravenous lidocaine suppresses fentanyl-induced cough

Objective To evaluate the effects of different doses of lidocaine on fentanyl-induced cough.Methods 200 patients,ASAⅠ-Ⅱ,aged 24-60 years old,scheduled for elective surgery under general anesthesia,were evenly randomized to four groups.The following medications were given within ten seconds： normal saline 10ml（group Ⅰ）,lidocaine 0.5 mg/kg（group Ⅱ）,lidocaine 1 mg/kg（group Ⅲ）,lidocaine 1.5 mg/kg（group Ⅳ）,all lidocaine was mixed with saline to 10ml.After 2min,the fentanyl 3ug/kg was given intravenously within 5 second.Cough incidence and cough grade were recorded within 5 min after the administration of fentanyl.Severity of coughing was graded based on the number of episodes of cough（mild,1-2;moderate,3-4;and severe,5 or more）.BP,HR and SpO2 were recorded during anesthesia.Results Cough occurrence was 40% in Group Ⅰ,while the frequencies of cough were significantly decreased in Group Ⅱ（16%）,Group Ⅲ（14%） and Group Ⅳ（14%）;there were no significant differences in the incidence and severity of cough among Group Ⅱ,Group Ⅲand Group Ⅳ（P0.05）.Conclusion Intravenous lidocaine is effective in suppressing fentanyl-induced cough and optimal dose is 0.5mg/kg.