术前肌注右美沙芬对全麻术后拔管时呛咳反应的影响

Effect of preoperative administration of Dextromethorphan on cough reflex during tracheal extubation

目的观察术前肌注右美沙芬（dextromethorphan，DM）对阻塞性睡眠呼吸暂停综合征（OSAS）患者全麻术后拔管时呛咳反应的影响。方法选择40例OSAS拟在全麻下行腭咽成型术（UPPD）患者，ASAⅠ～Ⅱ级，随机分为对照组及DM组，每组20例，术前30min分别肌注5ml生理盐水或DM0．3ms／kg，手术结束后拔管过程中观察各组呛咳反应的程度及不良反应。结果手术结束后拔管时，DM组与对照组比较，DM组呛咳反应程度明显低于对照组。结论术前30min肌肉注射DM0．3ms／kg可降低OSAS患者全麻下行UPPP术后呛咳反应的程度。

Objective To investigate the effect of preoperative administration of Dextromethorphan （DM） on cough reflex of patients during tracheal extubation under general anesthesia after obstructive sleep apnea syndrome （OSAS） operation. Methods Forty ASA Ⅰ -Ⅱ adult patients scheduled for uvulopalatopharyngoplasty （UPPP） under general anesthesia were randomly divided into control group and DM group （n = 20 in each group）. Patients in DM group received 0.3 mg/kg DM and control group took 5 ml normal saline preoperatively. Cough reflex of patients and adverse effects were recorded during tracheal extubation. Results Cough reflex during tracheal extubation was remarkably suppressed in DM group as compared with control group （P 〈 0. 05）. Conclusion Preoperative administration of DM in OSAS patients can significantly suppress cough reflex and reduce adverse effects during tracheal extubation after UPPP operation.