研究小剂量右美托咪定复合瑞芬太尼对全麻拔管期呛咳的影响

To Study the Effect of Low Dose Dexmedetomidine Combined with Remifentanil on Cough During Extubation under General Anesthesia

目的:探讨小剂量右美托咪定复合瑞芬太尼对全麻拔管期呛咳的影响。方法:选取2018年5月至2019年5月我院收治的全麻患者列为研究对象,80例患者按照1:1的方式分为两组,对照组患者静脉滴注生理盐水,研究组与对照组静脉滴注同等剂量生理盐水,同时静脉滴注小剂量右美托咪定复合瑞芬太尼,观察对比两组患者临床效果。结果:研究组无呛咳人数较对照组多,研究组轻度呛咳以及严重呛咳人数均低于对照组,研究组患者睁眼时间、自主呼吸恢复时间、定向力恢复时间、残存镇静作用均低于对照组,数据差异具有统计学意义(P<0.05);研究组患者的拔管时间较对照组短,但是两组患者的数据差异无统计学意义。结论:全麻拔管期使用小剂量右美托咪定复合瑞芬太尼,能有效地改善患者的呛咳现象,降低患者的呛咳程度,改善患者的麻醉后预后,患者的血流动力学更为平稳,预防效果更好,值得临床推广。

Objective: To investigate the effect of low dose dexmedetomidine combined with remifentanil on cough during extubation under general anesthesia. Methods: From May 2018 to may 2019, 80 patients with general anesthesia in our hospital were divided into two groups according to the 1: 1 method. The patients in the control group were intravenous drip with normal saline, and the patients in the study group and the control group were intravenous drip with the same dose of normal saline, while the patients in the control group were intravenous drip with small dose of right metoclopramide combined with remifentanil to observe and compare the clinical effect of the two groups. Results: The number of patients without choking cough in the study group was higher than that in the control group. the number of patients with mild choking cough and severe choking cough in the study group were lower than that in the control group. The patients in the study group had lower eye opening time, spontaneous breathing recovery time, directional force recovery time and residual sedation effect than that in the control group. The data difference was statistically significant(P<0.05). The extubation time of patients in the study group is shorter than that in the control group, but there is no statistical difference between the two groups. Conclusion: The use of small dose dexmedetomidine combined with remifentanil during extubation period of general anesthesia can effectively improve the choking cough phenomenon of patients, reduce the degree of choking cough of patients, and improve the prognosis of patients after anesthesia. It is worthy of clinical application.