静注右美托咪啶对预防瑞芬太尼引起的呛咳反应和诱导前后血流动力学的影响

目的：探讨静注右美托咪啶对预防瑞芬太尼引起的呛咳反应和诱导前后血流动力学的影响。方法：随机选择我院麻醉前ASA评分为Ⅰ-Ⅱ级的需进行择期手术的患者145例，随机将其分为两组：观察组73例，静注右美托咪啶后静注瑞芬太尼进行诱导麻醉；对照组：72例，静注生理盐水后静注瑞芬太尼进行诱导麻醉。比较两组之间的呛咳反应的程度与发生率、诱导前后心率、收缩压、舒张压及平均动脉压之间的变化差异。结果：观察组在瑞芬太尼静注30s后的呛咳反应发生率为21．92％，显著低于对照组，差异有统计学意义（ P＜0．05）；观察组在静注右美托咪啶后心率减慢、血压升高，明显优于静注右美托咪啶前，差异有统计学意义（ P＜0．05）；观察组静注右美托咪啶后心率减慢、血压升高明显优于对照组，差异有统计意义（ P＜0．05）。结论：静注右美托咪啶有效减少瑞芬太尼引起的呛咳反应的发生率并可使血流动力学稳定，值得临床推广使用。

Effects of Dexmedetomidine on Haemodynamics and Choking Cough Response Caused by Remifentanil

Objective：To observe the effects of dexmedetomidine on haemodynamics and choking cough response caused by remifentanil .Method：145 patients in level ASA I orⅡwere selected and divided into two groups randomly：observation group （ n=73） with dexmedetomidine and Remifentanil I .V.Control group （ n=72） with normal saline （ NS） and Remifentanil I .V.Choking cough reaction degree and incidence and heart rate ,SBP ,DBP and MAP were compared .Result： Choking cough response rates of observation group was less than that in control group , There＇s significant difference between the patients of two groups （ P〈0. 05）;Dexmedetomidine intravenous injection decreased heart rate and elevation of blood pressure more than control group, There＇s significant difference between the patients of two groups （P〈0.05）;After dexmedeto-midine intravenous injection decreased heart rate and elevation of blood pressure more than before dexme -detomidine intravenous injection , There＇s significant difference between the two groups of patients （ P〈0.05） . Conclusion：Dexmedetomidine is effective in lessening choking cough response caused by remifentaniland stabilizing haemodynamics .