右美托咪定对全身麻醉下甲状腺手术患者呛咳反应的影响

Effect of dexmedetomidine on choking response in patients undergoing general anesthesia for thyroid surgery

目的探讨右美托咪定对全身麻醉下甲状腺手术患者呛咳反应的影响。方法分析2015年10月至2017年3月本院收治的全身麻醉下实施甲状腺部分切除术患者80例，按照随机数字法分为观察组与对照组，各40例；对照组使用咪达唑仑进行围术期镇静，观察组使用右美托咪定；比较干预后两组恢复自主呼吸时间、拔管时间及麻醉恢复总时间，并统计两组呛咳发生率及呛咳评分。结果观察组恢复自主呼吸时间、拔管时间及麻醉恢复总时间分别为（11．4±1．5）min，（18．2±1．9）min和（35．5±3．2）min，均显著短于对照组的（15．5±1．9）min，（26．9±2．6）min和（40．9±3．6）min（均P〈0．05）；观察组呛咳发生率为27．5％，低于对照组的92．5％（P〈0．05）；观察组呛咳评分为（1．5±0．2）分，低于对照组的（3．1±0．4）分（P〈0．05）。结论对于甲状腺手术患者，围术期使用右美托咪定，能有效促进患者术后恢复，早期拔除气管导管，且减少呛咳反射发生率。

Objective To investigate the effect of dexmedetomidine on choking response in patients undergoing general anesthesia for thyroid surgery. Methods 80 patients undertaking partial thyroidectomy under general anesthesia from October, 2015 to March, 2017 were divided into an observation group and a control group by random number method, 40 cases for each group. The control group took midazolam for perioperative sedation and the observation group dextromethorphan. After the intervention, the time for restoring spontaneous breathing, extubation time, and anesthesia recovery time were compared between these two groups. And the incidences of choking and choking scores of these two groups were calculated. Results The time for restoring spontaneous breathing, the extubation time, and the total recovery time of anesthesia were （11.4 ± 1.5） min, （ 18.2± 1.9 ） min, and （ 35.5±3.2 ） min in the observation group and were （ 15.5±1.9 ） min, （ 26.9±2.6 ） min, and （ 40.9±3.6 ） min in the control group （all P 〈 0.05）. The incidence of cough was 27.5% in the observation group and was 92.5% in the control group （P 〈 0.05）. The choking score was （1.5 ± 0.2） in the observation group and was （3.1 ± 0.4） in the control group （P 〈 0.05）. Conclusion For patients undertaking thyroid surgery, perioperatively using dexmedetomidine can effectively promote the patients＇ recovery, early remove tracheal tube, and reduce the incidence of choking reflex.