右美托咪定对甲状腺肿瘤手术患者全麻恢复期间呛咳反应的影响

Effect of dexmedetomidine on cough response in patients undergoing thyroid tumor surgery during recovery from general anesthesia

目的探讨右美托咪定对甲状腺肿瘤手术患者全麻恢复期间呛咳反应的影响。方法选择2018年2月至2020年3月间在湛江市第一中医医院行手术治疗的76例甲状腺肿瘤患者,按随机数字表法分为干预组和对照组,每组各38例。干预组在手术开始时经微量注射泵持续泵注0.4μg/(kg·h)右美托咪定,直至手术结束;对照组同期泵注等容量生理盐水。比较两组麻醉用药情况、恢复时间、全麻恢复期间呛咳反应发生率和分级以及不良反应发生情况。结果干预组瑞芬太尼、丙泊酚用量较对照组低,差异有统计学意义(P<0.05);两组舒芬太尼、罗库溴铵用量、气管拔管时间、自主呼吸恢复时间和麻醉后监测治疗室(Post-anesthesia care unit,PACU)停留时间比较无统计学差异(P>0.05);干预组全麻恢复期间呛咳反应发生率和分级较对照组低,差异有统计学意义(P<0.05);干预组心动过速发生率较对照组低,差异有统计学意义(P<0.05)。结论甲状腺肿瘤手术中使用右美托咪定能够减少全麻恢复期间呛咳发生,减轻呛咳反应,减少不良反应的发生,提高手术安全性。

Objective To investigate the effect of dexmedetomidine on cough response in patients undergoing thyroid tumor surgery during recovery from general anesthesia.Methods The 76 patients with thyroid tumor who underwent surgical treatment in Zhanjiang First Hospital of Traditional Chinese Medicine from February 2018 to March 2020 were selected and divided into intervention group and control group according to the random number table method,with 38 cases in each group.The intervention group was injected with 0.4μg/(kg·h)dexmedetomidine through the microinjection pump at the beginning of the operation until the end of the operation;the control group was injected with equal volume of normal saline at the same time.The anesthesia medication,recovery time,the incidence and grade of coughing reaction during general anesthesia recovery,and the occurrence of adverse reactions were compared between the two groups.Results The dosage of remifentanil and propofol in the intervention group was lower than that in the control group(P<0.05).There was no significant difference in the dosage of sufentanil and rocuronium,extubation time,spontaneous breathing recovery time and post anesthesia care unit(PACU)stay between the two groups(P>0.05).The incidence and grade of cough reaction in the intervention group were lower than those in the control group(P<0.05).The incidence of tachycardia in the intervention group was lower than that in the control group(P<0.05).Conclusion The use of dexmedetomidine in thyroid tumor surgery can reduce the occurrence of cough during the recovery period of general anesthesia,reduce the cough reaction,reduce the occurrence of adverse reactions,and improve the safety of surgery.