瑞芬太尼与右美托咪定对于全麻手术患者拔管期呛咳与血流动力学指标的影响

Effects of Remifentanil and Dexmedetomidine on Coughing and Hemodynamic Indexes During Extubation of Patients Under General Anesthesia

目的对比瑞芬太尼与右美托咪定对于全麻手术患者拔管期呛咳与血流动力学指标的影响。方法选择2019年5月—2020年4月于该院行全麻手术的104例患者,以随机数字表法分为两组。两组麻醉诱导与麻醉维持方案相同,对照组52例持续泵入瑞芬太尼控制,研究组52例持续泵入右美托咪定。对比两组患者苏醒期呛咳的发生率与不同时间点血流动力学指标的变化。结果研究组苏醒期呛咳的发生率(5.77%)与对照组(7.69%)对比差异无统计学意义(χ^(2)=0.000,P>0.05)。研究组拔管时、拔管后1 min、拔管后5 min时平均动脉压(85.6±4.8)、(86.0±4.2)、(84.6±5.0)mmHg,心率(84.5±10.2)、(83.6±10.4)、(83.6±10.6)次/min低于对照组(95.6±8.3)、(95.4±5.0)、(90.5±4.8)mmHg,(92.5±11.2)、(93.5±11.3)、(92.0±10.2)次/min,差异有统计学意义(t=7.521、10.380、6.138、3.808、4.649、3.137,P<0.05)。结论瑞芬太尼与右美托咪定均可以预防全麻手术患者拔管期呛咳,其中持续泵入右美托咪定可以维持血流动力学指标的稳定性。

Objective To compare the effects of remifentanil and dexmedetomidine on coughing and hemodynamic indexes during extubation in patients undergoing general anesthesia.Methods A total of 104 patients who underwent general anesthesia in the hospital from May 2019 to April 2020 were selected and divided into two groups by random number table.The two groups of anesthesia induction and anesthesia maintenance program were the same,52 patients in the control group were continuously pumped with remifentanil,and 52 patients in the study group were continuously pumped with dexmedetomidine.The incidence of coughing during the recovery period and the changes of hemodynamic indicators at different time points were compared between the two groups of patients.Results There was no statistically significant difference in the incidence of coughing during the recovery period between the study group(5.77%)and the control group(7.69%)(χ^(2)=0.153,P>0.05).In the study group,the mean arterial pressures were(85.6±4.8)mmHg,(86.0±4.2)mmHg,and(84.6±5.0)mmHg,and the heart rate were(84.5±10.2)times/min,(83.6±10.4)times/min,(83.6±10.6)times/min at the time of extubation,1 min after extubation,and 5 min after extubation,which were lower than the control group(95.6±8.3)mmHg,(95.4±5.0)mmHg,(90.5±4.8)mmHg,(92.5±11.2)times/min,(93.5±11.3)times/min,(92.0±10.2)times/min,the difference was statistically significant(t=7.521,10.380,6.138,3.808,4.649,3.137,P<0.05).Conclusion Both remifentanil and dexmedetomidine can prevent coughing during extubation in patients undergoing general anesthesia,and continuous pumping of dexmedetomidine can maintain the stability of hemodynamic indicators.