右美托咪定对喉罩通气全麻下日间甲状腺切除术患者术后咽痛的影响  

Effect of dexmedetomidine on postoperative sore throat in patients undergoing ambulatory thyroidectomy under general anesthesia with I-gel laryngeal mask ventilation

作　　者：陆姚[1] 孙月 宁猛 钟薇薇[1] 刘学胜[1] LU Yao;SUN Yue;NING Meng;ZHONG Wei-wei;LIU Xue-sheng(Department of Anesthesiology,First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui,China)

机构地区：[1]安徽医科大学第一附属医院麻醉科,安徽合肥230022

出　　处：《广东医学》2022年第12期1512-1517,共6页Guangdong Medical Journal

基　　金：安徽省高校优秀青年人才重点项目(gxyqZD2018028);安徽医科大学校科研基金资助项目(2022xkj150)。

摘　　要：目的研究右美托咪定对I-gel喉罩通气全麻下日间甲状腺切除术患者术后咽痛的影响。方法选择择期行日间甲状腺切除术的患者66例,年龄18~65岁,性别不限,体质指数18~30 kg/m^(2),ASA分级Ⅰ~Ⅱ级。采用随机数字表法将患者分为两组,右美托咪定组(D组)和生理盐水组(C组),每组33例。在麻醉诱导前D组静脉泵注右美托咪定负荷剂量为0.5μg/kg,10 min泵注完毕,随后恒速泵注右美托咪定0.1μg/(kg·h)直至手术结束。C组在麻醉诱导前及手术结束前分别泵注相同量的生理盐水。记录喉罩置入所需时间、喉罩留置时间、麻醉药物用量、恢复室内的Ramsay评分。于麻醉诱导前基线(T0)、插管即刻(T1)、插管后1 min(T2)、插管后3 min(T3)、插管后5 min(T4)、手术结束时(T5)和拔管即刻(T6)分别记录平均动脉压和心率。于术后1 h(T7)、术后6 h(T8)、术后24 h(T9)分别记录术后咽痛及声嘶发生情况。记录术后24 h内恶心呕吐、低血压、心律失常的不良反应情况。结果D组与C组术后各时间点咽痛和声音嘶哑、及术后24 h内恶心呕吐的发生率差异无统计学意义(P>0.05)。但与C组比较,D组的丙泊酚用量减少,差异有统计学意义(P<0.05)。两组术后均未发生低血压及心律失常等不良事件。结论虽然右美托咪定辅助全身麻醉能减少全麻药物丙泊酚的用量,但其并没有降低I-gel喉罩通气全麻下日间甲状腺切除术患者术后咽痛发生率,没有对咽喉并发症方面显示出优异的结果。Objective To study the effect of dexmedetomidine on postoperative sore throat in patients undergoing daytime thyroidectomy under general anesthesia with I-gel laryngeal mask ventilation.Methods Sixty-six patients aged 18-65 years,regardless of gender,BMI 18-30 kg/m^(2),and ASA Grade Ⅰ-Ⅱ,who underwent thyroidectomy under daytime selective general anesthesia were selected.The patients were randomly divided into two groups,dexmedetomidine group(Group D)and normal saline group(Group C),33 cases in each group.Before anesthesia induction,Group D was injected with dexmedetomidine at a loading dose of 0.5μg/kg,which was completed in 10 minutes,and subsequently injected with dexmedetomidine at a constant rate of 0.1μg/(kg·h)until the end of the operation.Group C was pumped with the same amount of 0.9% normal saline before anesthesia induction and until the end of operation.The time required for laryngeal mask placement,laryngeal mask in place time,anesthesia time,operation time,dosage of anesthetic drugs and Ramsay score in recovery room were recorded.Mean arterial pressure and heart rate were recorded at baseline(T_(0));immediately after intubation(T_(1));1 min(T_(2)),3 min(T_(3)),and 5 min(T_(4))after intubation;at the end of operation(T_(5))and immediately after extubation(T6).The incidence of postoperative sore throat and hoarseness were recorded 1 h(T_(7)),6 h(T_(8))and 24 h(T_(9))after operation.The incidence of postoperative nausea and vomiting,hypotension and arrhythmia were recorded within 24 hours after operation.Results There was no significant difference between Group D and Group C in the incidence of postoperative sore throat,hoarseness,nausea and vomiting within 24 hours after operation.However,compared with Group C,the dosage of propofol in Group D significantly decreased(P<0.05).No postoperative adverse events such as hypotension or arrhythmias occurred in either group.Conclusion Although dexmedetomidine assisted general anesthesia can reduce the dosage of propofol,it doesn′t reduce the incidence

关 键 词：右美托咪定 术后咽痛 甲状腺手术 全身麻醉 

分 类 号：R614[医药卫生—麻醉学] R969[医药卫生—外科学]