右美托咪啶预防呛咳反应和气管插管心血管反应的临床观察

目的观察和评价预先静脉泵注右美托咪啶对芬太尼诱发呛咳反应的影响。方法 80例ASAⅠ～Ⅱ级择期全麻手术患者随机分为右美托咪啶组(观察组)和生理盐水组(对照组)各40例。观察组和对照组于麻醉诱导前分别静脉泵注右美托咪啶0.5μg/kg和等量生理盐水,泵注结束后于5s内静脉注射芬太尼3μg/kg。观察芬太尼诱发呛咳反应的例数和程度;记录麻醉前(T0)、泵注后即刻(T1)、气管插管前即刻(T2)、气管插管后1min(T3)、气管插管后3min(T4)的收缩压(SBP)及心率(HR)。结果观察组诱发呛咳反应的发生率明显低于对照组(P<0.05)。与T0比较,观察组T1时SBP升高,T1～T2时HR降低(P<0.05);对照组T2时SBP、HR降低,T3～T4时SBP、HR升高(P<0.05)。两组间比较,观察组T1～T2时SBP高于对照组,HR低于对照组(均P<0.05);T3～T4时SBP、HR均低于对照组(均P<0.05)。结论右美托咪啶可以降低芬太尼诱发呛咳反应的发生率,并能有效维持气管插管前后血流动力学稳定。

Clinical observation of right dexmedetomidine in prevention from cough response and cardiovascular response to tracheal intubation

Objective To observe and evaluate the pre-intravenous infusion right dexmedetomidine fentanyl-induced cough response. Methods 80 cases of ASA I -Ⅱ grade elective surgery under general anesthesia were randomly di- vided into right dexmedetomidine group （observation group） and normal saline （control group）, 40 cases in each. The observation group and control group before induction of anesthesia, intravenous pump Note dexmedetomidine the piperi- dine 0.5ug/kg and the same amount of saline after the end of infusion within 5s intravenous fentanyl 3ug/kg. Observe the number of cases and extent of fentanyl-induced cough reaction; recorded before anesthesia （To）, infusion immediately （T1）, immediately before intubation （T2）, after intubation 1rain （T3）, endotracheal intubation after 3min （T4）, systolic blood pressure （SBP） and heart rate （HR）. Results The incidence of induced cough response was significantly lower than the control group （P〈0. 05）. Compared with To ： observation group T1 SBP increased HR （P〈0. 05） reduction in T1-T2 ; control group at T2 SBP, HR lowering SBP, HR increased （P〈0. 05）, T3-T4. Between the two groups, obser- vation group TI-T2 SBP higher than that in the control group, HR lower than the control group （P〈0. 05） lower than the control group （P〈0. 05） ; T3-T4 SBP, HR. Conclusion Right dexmedetomidine can reduce the incidence of fentanyl- induced cough response and effective to maintain hemodynamic stability before and after intubation.