右美托咪定对甲状腺肿瘤手术全身麻醉恢复期间呛咳反应的影响  

Effect of dexmedetomidine on cough reactions during recovery from general anesthesia in thyroid tumor surgery

作　　者：林琳[1] 马松梅[1] 董晓辉[1] Lin Lin;Ma Songmei;Dong Xiaohui(Department of Anesthesiology,First People's Hospital of Shangqiu City,Shangqiu 476100,China)

机构地区：[1]河南省商丘市第一人民医院麻醉科,商丘476100

出　　处：《中华地方病学杂志》2023年第3期222-225,共4页Chinese Journal of Endemiology

摘　　要：目的:探讨右美托咪定对甲状腺肿瘤手术全身麻醉恢复期间呛咳反应及相关指标的影响。方法:选择在河南省商丘市第一人民医院于2019年7月至2021年7月行全身麻醉的甲状腺肿瘤手术患者90例,依据随机数字表法分为观察组(45例)与对照组(45例)。观察组于手术开始静脉滴注右美托咪定0.5 μg/kg,静脉滴注时间至少10 min;对照组给予等剂量生理盐水静脉滴注。比较两组患者苏醒时间和拔管时间,全身麻醉恢复期间呛咳反应发生率;术后6、24和48 h疼痛视觉模拟评分(VAS)变化;术前和术后48 h应激反应指标[皮质醇(Cor)、肾上腺素(E)和去甲肾上腺素(NE)]和疼痛因子[前列腺素E2(PGE2)、神经肽Y(NPY)和β-内啡肽(β-EP)]变化。结果:观察组苏醒时间和拔管时间[(15.62 ± 3.64)、(18.27 ± 4.25)min]均早于对照组[(23.12 ± 4.53)、(25.65 ± 3.89)min,均 P < 0.001]。观察组全身麻醉恢复期间呛咳反应发生率[8.89%(4/45)]低于对照组[28.89%(13/45), P = 0.015]。观察组术后6、24和48 h VAS均低于对照组(均 P < 0.001)。两组术后48 h血清Cor、E和NE水平均高于术前(均 P < 0.001);观察组术后48 h血清Cor、E和NE水平均低于对照组(均 P < 0.001)。两组术后48 h血清PGE2和NPY水平均高于术前,而β-EP水平低于术前(均 P < 0.001);观察组术后48 h血清PGE2和NPY水平均低于对照组,而β-EP水平高于对照组(均 P < 0.001)。 结论:右美托咪定可降低甲状腺肿瘤手术患者全身麻醉恢复期间呛咳反应,明显减轻疼痛,且对应激反应和疼痛因子影响小。Objective To explore the effect of dexmedetomidine on cough reactions and related indexes during recovery from general anesthesia in thyroid tumor surgery.Methods A total of 90 patients with thyroid tumor who underwent general anesthesia for thyroid tumor surgery from July 2019 to July 2021 in the First People's Hospital of Shangqiu City,Henan Province were selected and divided into the observation group(45 cases)and the control group(45 cases)according to the random number table method.The observation group was given dexmedetomidine 0.5μg/kg intravenously at the beginning of the surgery,and the intravenous drip time should not be less than 10 min;the control group was given the same dose of normal saline intravenously.The recovery time and extubation time of the two groups were compared,and the incidence of cough reactions during the recovery from general anesthesia was compared.Changes of visual analogue scale(VAS)of pain at 6 h,24 h and 48 h after surgery,and the changes of stress response indexes[cortisol(Cor),epinephrine(E)and norepinephrine(NE)]and pain factors[prostaglandin E2(PGE2),neuropeptide Y(NPY)andβ-endorphin(β-EP)]before and 48 h after surgery were compared.Results The recovery time and extubation time in the observation group[(15.62±3.64),(18.27±4.25)min]were faster than those in the control group[(23.12±4.53),(25.65±3.89)min,P<0.001].The incidence of cough reactions during recovery from general anesthesia in the observation group[8.89%(4/45)]was lower than that in the control group[28.89%(13/45),P=0.015].The VAS score in the observation group was lower than that in the control group at 6 h,24 h and 48 h after surgery(P<0.001).The levels of serum Cor,E and NE at 48 h after surgery in both groups were higher than those before surgery(P<0.001);and the serum Cor,E,and NE levels in the observation group were lower than those in the control group at 48 h after surgery(P<0.001).The serum PGE2 and NPY levels of the two groups at 48 h after surgery were higher than those before surgery,whileβ-EP l

关 键 词：甲状腺肿瘤 右美托咪定 手术 全身麻醉 呛咳反应 

分 类 号：R614[医药卫生—麻醉学] R736.1[医药卫生—外科学]