The Minimum Effective Dose Of Hydrochloride Oxycodone For The Prevention And Treatment Of Fentanyl-induced Cough During General Anesthesia Induction

Objective: This study was performed to investigate The minimum effective dose of hydrochloride oxycodone for the prevention and treatment of fentanylinduced cough during general anesthesia inductionMethods:120 patients,ASA I-II,aged 18-50 years old.Scheduled for breast tumor resection under general anesthesia Adopt the method of the table of random number,were randomly divided into four groups.Thirty patients in each group,who were injected a matching placebo(equal volume of 0.9% saline,group C)、hydrochloride oxycodone 60ug/kg(group OL)、 80ug/kg(group OM)、100ug/kg(group OH).All patients were fasted for 8 hours and deprived water for 4 hours before surgery.Patients entering the operating room and are opened peripheral venous access.Patients were required for anesthesia detection,including ECG、blood oxygen saturation、blood pressure(performed the invasive monitoring of radial artery when necessary)、PETCO2.In C 、OL、OM and OH groups,normal saline 5 ml and oxycodone hydrochloride injection 60ug/kg 、80ug/kg 、100ug/kg(in 5ml normal saline)were injected,respectively,5min later fentanyl 2ug/kg was injected intravenously over 3S,and 2min later other drugs for induction of anesthesia were given including midazolam 0.03mg/kg,、propofol 2mg/kg and Cisatracurium 0.2 mg/kg.Excessive ventilation 3 minutes later,make the concentration of the muscle relaxant peak for endotracheal intubation then mechanical ventilation,tidal volume 8-10ml/kg,PECO2 35-45 mmhg maintenance.Anesthesia was maintained with sevoflurane inhalation of 1.3 ~ 1.5 MCA.Observe and record the incidence and degree of cough within 2 min after injection of fentanyl,Mean blood pressure(MBP),heart rate(HR),pulse oxygen saturation(SPO2),Incidence and the incidence of adverse reactions in operation,inhibition of respiration(RR < 10 or Sp O2 < 90% / min,bradycardia(HR < 50 / min.).Postoperative nausea and vomiting were recorded before anesthesia(T0),after drip oxycodone or saline intravenous 2 min(T1),before intubation(T2),1min after intubation(T3),5 min after intubation(T4).)Results:All groups of HR and MAP was not statistically significant in T0.OH group compared with the rest of the three groups,the T1,T2,T3,T4 period of HR and MAP decreased significantly(P<0.05).HR and MAP in C group were increased significantly in the T3 period than the other three groups(P<0.05).There was no significant difference in SPO2 between the four groups(P>0.05).C group of 22 cases of cough reaction(73.33%),OL group(n = 36.67%),OM group of a total of 2 cases(6.67%),OH group of a total of 1 cases(3.33%).,OM group,The incidence and intensity of cough were lower in groups of OL,OM and OH than that in groups C(P<0.05).The incidence and intensity of cough was higer in groups of OL than that in groups OM and OH(P<0.05),OH group and OM group did not have significant difference(P>0.05).Conclusion : These results demonstrate that intravenous hydrochloride Oxycodone 80ug/kg in 5min before induction of anesthesia by intravenous injection is effectively reduce the incidence of fentanyl-induced cough in our patients.