Role Of Nalmefene In Prevention Of Sufentanil-induced Cough In Patients With Induction Of Cardiac Anesthesia

Objective:To observe the role of nalmefene in prevention of sufentanil-induced cough(SFIC)in patients with induction of general anesthesia for cardiac surgery and judge its influence on hemodynamic during tracheal intubation.Methods:Sixty patients with ASA?or ?undergoing cardiac surgery were randomly divided into two groups by computer.All patients were fasted for 12 hours before induction of anesthesia,taked diazepam 10 mg 2 hours before induction of anesthesia and injected with scopolamine 0.3 mg 30 minutes before induction of anesthesia.0.25?g/kg of hydrochloric acid natrium nalmefene(diluted to 10 ml,slow injected in 2 minutes)and the same capacity of physiological saline was applied at the same speed 5 minutes before induction of intravenous for nalmefene group(group N)and the control group(group C)respectively.Coughing cases(counted the number of cases occurred and calculated the incidence rate)and the intensity grade in 60 seconds after sufentanil injection,vital signs(blood pressure(BP),heart rate(HR),pulse oxygen saturation(SPO2)and bispectral index(BIS))before the nalmefene injection(T0),before anesthesia induction(T1),60 seconds after sufentanil injection(T2)and after tracheal intubation(T3)were observed between two groups.Results:Incidence rate of sufentanil-induced cough was 10% in group N which was significantly lower than 60% in group C(P<0.05).The intensity grade of sufentanil-induced cough in group C was much more obvious than that in group N(P<0.05).The hemodynamic parameters(SBP?DBP?MAP?HR?BIS)of patients in 60 seconds after sufentanil injection in group N were much more steady than that in group C(P<0.05).The hemodynamic changes and BIS induced by tracheal intubation of the two groups was no significant difference(P > 0.05).The stimulation induced by tracheal intubation of two groups all could be effectively inhibited by sufentanil(P < 0.05).Conclusion:Preventive injection of 0.25?g/kg hydrochloric acid natrium nalmefene can effectively reduce the intensity and incidence of cough response induced by sufentanil injection during induction of cardiac anesthesia and improve the hemodynamic instability,but there was no effect on suppression of the responses to tracheal intubation by sufentanil in patients with induction of general anesthesia.