气管拔管前应用右美托咪定对甲状腺手术患者麻醉复苏的影响

目的: 观察甲状腺手术患者全麻气管拔管前静脉泵注右美托咪定(DEX)对麻醉复苏的影响.方法: 74例甲状腺手术患者随机分为观察组和对照组各37例,观察组术毕10 min时静脉泵注DEX 0.5 μg/kg 10 min,对照组以0.9%氯化钠注射液10 ml同时间泵完.比较2组患者血压、心率、脉搏和血氧饱和度变化、术毕清醒睁眼时间及拔管时间,记录气管拔管前患者呛咳、恶心、呕吐等不良反应发生情况和术后1 ~4 h舒适评分(BCS)及痛觉模拟评分(VAS).结果: 2组患者术毕拔管时间差异无统计学意义(P >0.05);观察组在泵注DEX后心率有所减慢(P< 0.01);对照组气管拔管时患者呛咳发生率高于观察组,且心率、血压升高(P< 0.05~P< 0.01);对照组术后1~4 h BCS评分低于观察组,VAS评分高于观察组(P< 0.01).结论: 甲状腺手术患者全麻拔管期间应用DEX可获得较好的镇痛、镇静效果,能够在一定程度上有效降低呛咳不良反应发生率,增加患者术后舒适度.

Effect of dexmedetomidine injection before tracheal extubation on the anesthetic recovery of patients with thyroid surgery

Objective: To observe the effects of dexmedetomidine(DEX) injection before tracheal extubation on the anesthetic recovery of patients.Methods: Seventy-four thyroid surgery patients were randomly divided into the observation group and control group(37 cases each group).which were treated with 0.5 μg/kg of DEX for 10 min and 10 ml of 0.9% sodium chloride solution by intravenous infusion at 10 min after operation,respectively.The blood pressure,heart rate(HR),pulse oxygen saturation and the time of postoperative awake and extubation in two groups were compared,the adverse reactions(including cough,nausea and vomiting) before tracheal extubation,and postoperative 1 to 4 h Bruggrmann comfort score(BCS) and visual analogue scale(VAS) in two groups were observed.Results: The difference of the extubation time between two groups was not statistically significant(P >0.05).The HR in the observation group decreased after injecting DEX.Compared with the observation group,the incidence of cough in control group was high,and its BP and HR increased significantly at the time of extubation(P< 0.05 to P< 0.01).Compared with the observation group,the postoperative 1 to 4 h BCS and VAS in control group were low and high,respectively(P< 0.05).Conclusions: The DEX injection in thyroid surgery patients during extubation has good analgesic and sedative effects,which can effectively reduce the incidence of cough,and improve the comfortable degree of patients after operation.