在全身麻醉誘導(dǎo)期間為避免患者嗆咳和血流動(dòng)力學(xué)波動(dòng)的舒芬太尼推薦劑量
貴州醫(yī)科大 麻醉與心臟電生理課題組
翻譯：嚴(yán)旭 編輯：柏雪 審校：曹瑩
背景：舒芬太尼引起的咳嗽（SIC）是麻醉誘導(dǎo)過(guò)程中常見(jiàn)的并發(fā)癥。我們通過(guò)一項(xiàng)臨床試驗(yàn)，分析了避免嗆咳、血流動(dòng)力學(xué)波動(dòng)和不良反應(yīng)的有效劑量(ED)ED50和ED95，探索了在全身麻醉期間有效避免咳嗽的舒芬太尼劑量。
方法：136名患者（ASA I-II）根據(jù)舒芬太尼劑量隨機(jī)分配到以下組：I組:0.1ug/kg；II組:0.3ug/kg；III組:0.5ug/kg；或IV組:1.0ug/kg。記錄并分析了注射舒芬太尼后1分鐘內(nèi)咳嗽、頭暈、恐慌和胸悶的次數(shù)，以及插管后5分鐘患者的心率（HR）和血壓?？人栽u(píng)估如下，無(wú):0次/分鐘；輕度:1至2次/分鐘；中度:3至4次/分鐘；嚴(yán)重:5次/分鐘或更多。
結(jié)果：在全身麻醉誘導(dǎo)期間，靜脈注射舒芬太尼引起的咳嗽發(fā)生率ED50和ED95分別為0.332ug/kg和1.423ug/kg。I組的咳嗽率比其他組低。頭暈、恐慌、胸悶、高血壓、心動(dòng)過(guò)緩和心動(dòng)過(guò)速的發(fā)生率沒(méi)有顯著差異。
結(jié)論：全身麻醉誘導(dǎo)期間推薦的舒芬太尼劑量為0.1ug/kg。
原始文獻(xiàn)來(lái)源：Ping Chen , Ping Zeng , Yuan Gong ,Recommended dose of sufentanil during induction of general anesthesia to avoid coughing and drastic hemodynamic fluctuations in patients undergoing surgery[J],J Int Med Res. 2021 Mar;49(3):300060521996143.
doi: 10.1177/0300060521996143.
Recommended dose of sufentanil during induction of general anesthesia to avoid coughing and drastic hemodynamic fluctuations in patients undergoing surgery
Background: Sufentanil-induced cough (SIC) is a common complication during anesthesia induction. We explored the recommended sufentanil dose that effectively avoids cough during general anesthesia using a clinical trial to analyze the effective dose (ED)50 and ED95 of sufentanil that avoids cough, hemodynamic fluctuations, and adverse reactions.
Methods: On the basis of sufentanil dose, 136 patients (ASA class I-II) were randomly allocated into the following groups: I, 0.1 μg/kg; II, 0.3 μg/kg; III, 0.5 μg/kg; or IV, 1.0 μg/kg. The number of coughing incidents, dizziness, panic, and chest tightness within 1 minute after sufentanil injection, and the patient's heart rate (HR) and blood pressure 5 minutes after intubation were recorded and analyzed. Cough was assessed as follows: none, 0 times; mild, 1 to 2 times/minute; moderate, 3 to 4 times/minute; and severe, 5 times/minute or more.
Results: The ED50 and ED95 of cough incidence induced by intravenous sufentanil in patients during general anesthesia induction was 0.332 μg/kg and 1.423 μg/kg, respectively. The cough rate in group I was lower than the other groups. The incidence of dizziness, panic, chest tightness, hypertension, bradycardia, and tachycardia were not significantly different.
Conclusions: The recommended sufentanil dose during general anesthesia induction is 0.1 μg/kg.
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