右美托咪定预处理防治瑞芬太尼诱发咳嗽反射

Effect of pretreatment with small dose dexmedetomidine on remifentanil-induced cough

目的:观察全麻诱导前给予小剂量右美托咪定预处理在抑制瑞芬太尼诱发咳嗽反射中的作用。方法:选取全身麻醉下行妇科腹腔镜或开腹良性子宫或卵巢肿瘤手术的患者180例,随机分为右美托咪定组和安慰剂组,每组90例。患者入室后面罩吸氧,右美托咪定组给予0.9%生理盐水稀释至4μg·mL^(-1)的右美托咪定,对照组给予0.9%生理盐水50 mL,按照0.5μg·kg^(-1)不少于10 min泵入。10 min后开始泵入瑞芬太尼效应室靶控3 ng·mL^(-1),观察1 min,记录给瑞芬太尼后1 min内患者出现咳嗽的情况。记录麻醉时间、丙泊酚及瑞芬太尼的用量,记录给药后患者血压、心率、氧饱和度及BIS变化。结果:右美托咪定组患者发生瑞芬太尼诱发咳嗽反射的情况明显少于安慰剂组患者(P<0.01),咳嗽的严重程度也明显轻于安慰剂组患者(P<0.01)。结论:小剂量右美托咪定预处理对瑞芬太尼诱发的咳嗽反射有明显的抑制作用。

Objective： To investigate the effect of pretreatment with small dose dexmedetomidine on remifentanil-induced cough. Methods： A total of 180 patients were randomly divided into either dexmedetomidine（Dex,n = 90） and control（n = 90） group. After mask oxygen-inspiration,dexmedetomidine（0. 5 μg·kg^（-1） diluted by saline to 4 μg·mL^（-1）,Dex group） or same volume of saline（control group） was intravenously injected over 10 min. Ten minutes later,remifentanil target controlled injection at 3 ng·mL^（-1） was done,and the incidence of cough in 1 min was carefully observed. The duration of anesthesia,and the doses of propofol and remifentanil were recorded. Blood pressure,heart rate and Sp O2 were recorded after induction anesthesia. Results： The incidence and severity of cough were significant lower in Dex group than that in control group（P〈0. 01）.Conclusion： Pretreatment with small-dose intravenous dexmedetomidine can effectively prevent remifentanilinduced cough during the induction of general anesthesia.