性别对瑞芬太尼抑制全身麻醉苏醒期呛咳反射作用的影响

doi:10.3881/j.issn.1000-503X.2015.03.017

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2015, Vol. 37 ›› Issue (3): 335-338.doi: 10.3881/j.issn.1000-503X.2015.03.017

• Orginal Article • Previous Articles Next Articles

Influence of Sex on Remifentanil’s Cough-prevention Effect during Anesthetic Emergence

Xu-lei CUI, Man-jiao MA, Ling WANG(), Xue-rong YU, Yu-guang HUANG

Department of Anesthesiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China

Received:2015-03-26 Online:2015-05-23 Published:2015-06-30

Abstract

Abstract: Objective

To investigate the influence of sex on the cough-preventing effect of target-controlled infusion(TCI)of remifentanil during anesthetic emergence.

Methods

A total of 25 female(group F)and 25 male(group M)patients undergoing thyroidectomy were recruited in the current study. Anesthesia was maintained with sevoflurane and remifentanil TCI.At the end of the surgery,inhalational anesthetics were discontinued,and remifentanil TCI at an effect-site concentration(Ce)of 2.0 ng/ml was maintained during emergence until extubation. The cough score,blood pressure,and heart rate(HR)during peri-extubation period as well as the respiratory rate,calm score,and sore throat score after extubation were evaluated.

Results

During extubation,the proportion of patients with no cough or just a single cough was significantly higher in group F than in group M(88% vs. 64%,P=0.047). Mean arterial pressure(P=0.025,P=0.037)and HR(P=0.035)were significantly increased during extubation compared with preoperative levels in group M.

Conclusions

Sex may influence the cough-preventing effect of remifentanil TCI during anesthetic emergence. At a Ce of 2.0 ng/ml,remifentanil has better cough-preventing effect and more stable hemodynamic status in females than in males.

Key words: remifentanil, anesthesia recovery period, cough, sex

CLC Number:

R614.2⁺1

Xu-lei CUI, Man-jiao MA, Ling WANG, Xue-rong YU, Yu-guang HUANG. Influence of Sex on Remifentanil’s Cough-prevention Effect during Anesthetic Emergence[J].Acta Academiae Medicinae Sinica, 2015, 37(3): 335-338.

Figures/Tables 1

References 15

[1]	Kim ES,Bishop MJ.Cough during emergence from isoflurane anesthesia[J]. Anesth Analg,1998,87(5):1170-1174.
[2]	Caloòp G,Pisano G,Piga G,et al.Postoperative hematomas after thyroid surgery. Incidence and risk factors in our experience[J]. Ann Ital Chir,2010,81(5):343-347.
[3]	Nho JS,Lee SY,Kang JM,et al.Effects of maintaining a remifentanil infusion on the recovery profiles during emergence from anaesthesia and tracheal extubation[J]. Br J Anaesth,2009,103(6):817-821.
[4]	Chen J,Li W,Wang D,et al.The effect of remifentanil on cough suppression after endoscopic sinus surgery:a randomized study[J]. Acta Anaesthesiol Scand,2010,54(10):1197-1203.
[5]	Lee B,Lee JR,Na S.Targeting smooth emergence:the effect site concentration of remifentanil for preventing cough during emergence during propofol-remifentanil anaesthesia for thyroid surgery[J].Br J Anaesth,2009,102(6):775-778.
[6]	Choi EM,Park WK,Choi SH,et al.Smooth emergence in men undergoing nasal surgery:the effect site concentration of remifentanil for preventing cough after sevoflurane-balanced anaesthesia[J]. Acta Anaesthesiol Scand, 2012,56(4):498-503.
[7]	Nho JS,Lee SY,Kang JM,et al.Effects of maintaining a remifentanil infusion on the recovery profiles during emergence from anaesthesia and tracheal extubation[J]. Br J Anaesth,2009,103(6):817-821.
[8]	Dahan A,Kest B,Waxman AR,et al.Sex-specific responses to opiates:animal and human studies[J]. Anesth Analg,2008,107(1):83-95.
[9]	Kamei J.Role of opioidergic and serotonergic mechanisms in cough and antitussives[J]. Pulm Pharmacol,1996,9(5-6):349-356.
[10]	Marks S,Rosielle DA.Opioids for cough # 199[J]. J Palliat Med,2010,13(6):769-770.
[11]	Jun NH,Lee JW,Song JW,et al.Optimal effect-site concentration of remifentanil for preventing cough during emergence from sevoflurane-remifentanil anaesthesia[J]. Anaesthesia,2010,65(9):930-935.
[12]	Chia YY,Chow LH,Hung CC,et al.Gender and pain upon movement are associated with the requirements for postoperative patient-controlled iv analgesia:a prospective survey of 2,298 Chinese patients[J]. Can J Anaesth,2002,49(3):249-255.
[13]	Dahan A,Sarton E,Teppema L,et al.Sex-related differences in the influence of morphine on ventilatory control in humans[J]. Anesthesiology,1998,88(4):903-913.
[14]	Zubieta JK,Dannals RF,Frost JJ.Gender and age influences on human brain mu-opioid receptor binding measured by PET[J].Am J Psychiatry,1999,156(6):842-848.
[15]	Zubieta JK,Smith YR,Bueller JA,et al.mu-opioid receptor-mediated antinociceptive responses differ in men and women[J]. J Neurosci,2002,22(12):5100-5107.

分组 Group	手术结束至给肌松拮抗的时间 Time to reversal (min)			手术结束至患者睁眼的时间 Time to eye opening (min)			手术结束至拔管的时间 Time to extubation (min)			Narcotrend值Narcotrend value
分组 Group	手术结束至给肌松拮抗的时间 Time to reversal (min)			手术结束至患者睁眼的时间 Time to eye opening (min)						手术结束 End of operation					拔管 Extubation			拔管后2 min 2 min after extubation		拔管后4 min 4 min after extubation
女性Female	3.2±1.0			7.6±2.6						9.1±2.9			58.0± 9.0			87.0±11.0			91.3± 7.2		88.6± 9.9
男性Male	3.8±1.6			7.7±2.8			9.2±2.7			56.6±10.8			91.8±10.0			91.0±14.1			89.6±14.1
分组 Group	拔管后呼吸频率(次/min) Respiratory rate after extubation(breath/min)								拔管后氧饱和度(%) SpO₂ after extubation(%)									需芬太尼补救镇痛的例数 Number of rescue fentanyl
分组 Group	2 min		4 min					10 min			2 min			4 min			10 min
女性Female	16.3±2.8		16.3±3.0			17.8±9.9			99.3±0.6			99.2±0.8			99.0±0.9			3
男性Male	16.4±4.7		14.8±3.0			14.6±2.7			99.5±0.7			99.2±0.7			99.0±0.8			5
分组 Group	拔管后咽痛评分(得0或1分的患者例数/ 得2或3分的患者例数) Sore throat score after extubation(ration of patients with score=0 or 1/score=2 or 3)										拔管后镇静评分(得0或1分的患者例数/ 得2或3分的患者例数) Calm score after extubation(ratio of patients with score=0 or 1/score=2 or 3)
分组 Group	1 min	5 min			10 min			30 min			1 min			5 min			10 min			30 min
女性Female	25/0	25/0			24/1			18/5			14/11			12/13			17/8			22/3
男性Male	25/0	24/1			23/2			19/4			18/7			12/13			20/5			21/4

Acta Academiae Medicinae Sinica

Home

About Journal

Current Issue

Archive

Search

Contact Us

中文

Influence of Sex on Remifentanil’s Cough-prevention Effect during Anesthetic Emergence

RichHTML

PDF (PC)

Like

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 1

References 15

Related Articles 8

Metrics

Recommended 10

[1]	YIN Huaqi, QIN Caipeng, ZHANG Xiaowei, XU Tao. Research Advances in Sex Determining Region Y Box 18 in Tumors [J]. Acta Academiae Medicinae Sinica, 2018, 40(1): 98-103.
[2]	XU Jian-qing,ZHANG Jing. Correlation between Analgesia in the Postanesthesia Care Unit and Intraoperative Remifentanil [J]. Acta Academiae Medicinae Sinica, 2014, 36(4): 385-388.
[3]	CHEN Zhi-ye,LI Jin-feng,LIU Meng-yu,MA Lin. Impact of Gender on the Marginal Division of the Neostriatum in Health Adults [J]. Acta Academiae Medicinae Sinica, 2013, 35(3): 294-298.
[4]	WEI Lingxin, DENG Xiaoming, WANG Lei, SUI Jinghu, ZHANG Yanming, TONG Shiyi, TANG Gengzhi, XU Kunlin. Induction of Tracheal Intubation without Muscle Relaxant by Target controlled Infusion of Propofol Combined with Remifentanil in Children [J]. Acta Academiae Medicinae Sinica, 2011, 33(4): 440-444.
[5]	XU Jian-qing, YE Tie-hu, HUANG Yu-guang, LUO Ai-lun. Application of Propofol Target controlled Infusion Combined with Dribbled and Nebulized Lidocaine in Tracheal Intubation under Spontaneous Respiration [J]. Acta Academiae Medicinae Sinica, 2010, 32(5): 569-573.
[6]	SUN Hai-tao;XUE Fu-shan;LIU Kun-peng;SUN Li;XU Ya-chao;LIAO Xu;YANG Quan-yong;ZHANG Yan-ming. Effect of Remifentanil Preconditioning on Myocardial Ischemia-reperfusion Injury [J]. Acta Academiae Medicinae Sinica, 2009, 31(5): 612-615.
[7]	WEI Ling-xin；DENG Xiao-ming；LIU Ju-hui；LUO Mao-ping； TONG Shi-yi； ZHANG Yan-ming； LIAO Xu； XU Kun-lin. Inductions and Intubating Conditions with Sevoflurane and Different Doses of Remifentanil without Muscle Relaxant in Children [J]. Acta Academiae Medicinae Sinica, 2008, 30(6): 723-727.
[8]	WANG Zhi-hong,, LIN Jiang-tao, LI Yong, GAO Jie, ZHU Jia-jia. Etiological Diagnosis and Specific Treatment of Chronic Cough in 106 Patients [J]. Acta Academiae Medicinae Sinica, 2007, 29(5): 665-668.