瑞芬太尼与右美托咪定预防全麻苏醒期呛咳反射的效果及对患者血流动力学的影响比较  

Effect of remifentanil and dexmedetomidine on prevention of cough reflex and hemodynamics in patients during awakening period of general anesthesia

作　　者：陈光[1] CHEN Guang(Department of Anesthesiology,Xinmin People's Hospital,Xinmin,Liaoning,110300,China)

机构地区：[1]新民市人民医院麻醉科,辽宁新民110300

出　　处：《当代医学》2022年第21期47-50,共4页Contemporary Medicine

摘　　要：目的 探讨应用瑞芬太尼与右美托咪定预防全麻苏醒期患者呛咳反射的效果及对血流动力学的影响。方法 选取2018年8月至2020年8月本院收治的68例全麻苏醒期患者作为研究对象,根据随机数字表法分为常规组(采用右美托咪定麻醉)与研究组(采用瑞芬太尼麻醉),各34例。比较两组睁眼时间、拔管时间、麻醉恢复室(PACU)停留时间、心率、血压、呛咳程度、镇静程度、咽痛程度。结果 拔管期间,研究组呛咳评分(1.2±0.3)分,低于常规组的(2.6±0.7)分(P<0.05);拔管时、拔管后10 min,研究组血压均低于常规组,心率高于常规组(P<0.05);两组睁眼时间、拔管时间比较差异无统计学意义,研究组PACU停留时间短于常规组(P<0.05);研究组镇静评分低于常规组(P<0.05),两组咽痛评分比较差异无统计学意义。结论 全身麻醉苏醒过程中,与右美托咪定比较,瑞芬太尼对预防血压水平升高、预防呛咳反射、缩短PACU停留时间等方面的作用更显著,且镇静效果、稳定心率更佳,拔管后呼吸抑制不良反应发生率低,不影响患者苏醒时间。Objective To investigate the effect of remifentanil and dexmedetomidine on the prevention of cough reflex and its effect on hemodynamics in patients with awakening under general anesthesia. Methods A total of 68 patients with awakening period of general anesthesia admitted to our hospital from August 2018 to August 2020 during the recovery stage of general anesthesia were selected as the study subjects, and they were divided into the conventional group(dexmedetomidine anesthesia) and the study group(remifentanil anesthesia) according to the random number table method, with 34 cases in each group. The eye opening time, extubation time, postanesthesia care unit(PACU) stay time, heart rate, blood pressure,degree of choking, degree of sedation and degree of pharyngeal pain were compared between the two groups. Results During extubation, the cough score of the study group was(1.2±0.3) scores, which was lower than(2.6±0.7) scores of the conventional group(P<0.05). During extubation and 10min after extubation, the blood pressure in the study group was lower than that in the conventional group, and heart rate was higher than that in the conventional group(P<0.05). There were no significant differences in eye opening time and extubation time between the two groups. PACU retention time in the study group was shorter than that in the conventional group(P<0.05). The sedation score of the study group was lower than that of the conventional group(P<0.05), and there was no significant difference in the pharyngeal pain score between the two groups. Conclusion Compared with dexmedetomidine, remifentanil has more significant effect on preventing elevated blood pressure, preventing choking reflex and shortening the retention time of PACU during recovery from general anesthesia. Remifentanil also has better sedation effect and stable heart rate, and has a lower incidence of respiratory depression adverse reactions after extubation, which does not affect the recovery time of patients.

关 键 词：全麻苏醒期 瑞芬太尼 右美托咪定 呛咳反射 血流动力学 

分 类 号：R614.2[医药卫生—麻醉学]