芬太尼诱导儿童咳嗽频率及其对气管插管的影响
2010/07/07
研究目的：明确芬太尼诱导儿童咳嗽是否具有剂量依赖性及其对气管插管的影响。
设计：本试验为前瞻性、随机、双盲试验。
参与机构：韩国首尔Ewha女子大学附属医院手术室。
患者：160名ASA评分为I的患儿（2～14岁），全麻下口腔气管插管后行择期手术。
干预：将患者分为两组。1组患者给予1 mg/kg芬太尼； 2组患者给予2 mg/kg芬太尼。咳嗽停止后立即行全麻，或注射异丙酚（2.5 mg/kg）后1分钟行全麻。睫毛反射消失后，静脉给予罗库溴铵（0.6 mg/kg）。2分钟后行气管插管。
检测方法：观察记录咳嗽发作时间和咳嗽程度以及气管插管的情况。
主要结果：两组患者之间咳嗽频率或插管无显著差异。1组患者咳嗽严重程度明显低于2组（P<0.05），2组患者咳嗽发作时间（12.2+/-3.4秒）显著短于1组（16.9+/-7.6秒，P<0.05）。
结论：1或2 mg/kg芬太尼可以诱导患儿咳嗽。
（陈欣 审校）
Han JI, et al. J Clin Anesth. 2010 Feb;22(1):3-6.
The frequency of fentanyl-induced cough in children and its effects on tracheal intubation.
Han JI, Lee H, Kim CH, Lee GY.
Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul 158-710, South Korea. hanji@ewha.ac.kr hanji@ewha.ac.kr
STUDY OBJECTIVE: To determine if fentanyl-induced cough was dose-dependent in children and whether it could affect tracheal intubation.
DESIGN: Prospective, randomized, double-blinded study. SETTING: Operating room of a university-affiliated hospital.
PATIENTS: 160 ASA physical status I pediatric patients, aged two to 14 years, scheduled for elective surgery during general anesthesia and requiring orotracheal intubation.
INTERVENTIONS: Patients were divided into two groups. Group 1 patients were given fentanyl at a dosage of one microg/kg; Group 2 patients received two microg/kg of fentanyl. Induction of anesthesia was conducted immediately following cough cessation or one minute after the end of injection with propofol 2.5 mg/kg. At loss of eyelash reflex, rocuronium 0.6 mg/kg was given intravenously (IV). Two minutes later, tracheal intubation was started.
MEASUREMENTS: Onset and degree of cough and intubating conditions were observed and recorded.
MAIN RESULTS: No statistically significant differences in frequency of coughing or in intubating conditions between the two groups were noted. Cough severity in Group 1 was statistically lower than that of Group 2 (P < 0.05). Onset of cough in Group 2 (12.2 +/- 3.4 sec) was statistically shorter than in Group 1 (16.9 +/- 7.6 sec, P < 0.05).
CONCLUSION: Fentanyl at doses of one and two microg/kg may induce coughing in pediatric patients.
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儿童和成人咳嗽的诊断和评估：澳大利亚咳嗽指南总结
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门诊咳嗽评估：便携式自动咳嗽分析仪
