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| 右美托咪定对甲状腺手术患者呛咳反应的影响 |
| Effects of dexmedetomidine on postoperative cough reflex and the postoperative bleeding in patients undergoing thyroid surgery |
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| DOI： |
| 中文关键词: 右美托咪定 甲状腺手术 呛咳 术后出血 |
| 英文关键词: Dexmedetomidine Thyroid surgery Coughing Postoperative bleeding |
| 基金项目:重庆市科技惠民计划集成示范项目(cstc2015jcsf10008) |
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| 中文摘要: |
| 目的 探讨右美托咪定对甲状腺手术患者呛咳反应的影响。方法 择期全麻下甲状腺肿瘤手术患者118例,男43例,女75例,年龄18～65岁,BMI 18～30 kg/m2,ASA Ⅰ或Ⅱ级,采用随机数字表法分为两组,每组59例。D组在手术开始时持续静脉泵注右美托咪定0.4 μg·kg-1·h-1至手术结束,C组在手术开始时持续静脉泵注等容量生理盐水至手术结束。观察患者全麻恢复期间呛咳发生情况,记录患者术后24、48 h引流量,以及心动过速、低血压、高血压、心动过缓等不良反应的发生情况。结果 D组全麻恢复期间呛咳发生率明显低于C组(10.1% vs 30.5%, P＜0.05),D组术后第1个24 h［(62.3±26.8)ml vs (78.6±30.1)ml,P＜0.05］、第2个24 h［(28.0±12.5)ml vs (37.5±18.6)ml,P＜0.05］引流量明显少于C组; D组围术期心动过速发生率明显低于C组(3.4% vs 23.7%,P＜0.05)。结论 术中持续输注右美托咪定0.4 μg·kg-1·h-1能够有效减轻甲状腺手术患者全麻恢复期间的呛咳反应,降低患者术后出血的风险。 |
| 英文摘要: |
| Objective To evaluate the effect of dexmedetomidine on postoperative cough and the postoperative bleeding in patients undergoing thyroid surgery. Methods A total of 118 aged 18-65 years, BMI 18 30 kg/m2, ASA physical status Ⅰ or Ⅱ patients, scheduled for elective thyroid surgery, were randomly divided into 2 groups (n=59 each): dexmedetomidine group (group D) and control group (group C). At the beginning of the operation, patients in group D were infused with dexmedetomidine at a rate of 0.4 μg·kg-1·h-1 until the end of surgery. Meanwhile, the equal volume of normal saline was infused in group C. The incidence and severity of coughing during recovery, the volume of drainage at first and second 24 h after surgery, the occurrence of adverse events were recorded. Results Compared with group C, the incidence of coughing were lower in group D (10.1% vs 30.5%, P＜0.05). The volume of drainage at first 24 h ［（62.3±26.8） ml vs （78.6±30.1） ml, P＜0.05］ and second 24 h [(28.0±12.5） ml vs （37.5±18.6） ml, P＜0.05] after surgery were less in group D than those in group C. Compared with group C, the dosage of propofol and remifentanil were lower in group D (P＜0.05). Compared with group C, the incidence of tachycardia during recovery decreased in group D (3.4% vs 23.7%, P＜0.05). Conclusion Continuous infusion of dexmedetomidine at a rate of 0.4 μg·kg-1·h-1 in patients undergoing thyroid surgery with general anesthesia can relieve cough reflex, reduce the risk of the postoperative bleeding. |
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