药物流行病学杂志2024,Vol.33Issue(4) :402-409.DOI:10.12173/j.issn.1005-0698.202401052

瑞马唑仑和右美托咪定对甲状腺手术全麻苏醒期呛咳抑制效果的比较

Comparison of the effects of remimazolam and dexmedetomidine on inhibiting cough during emergence from general anesthesia in patients undergoing thyroid surgery

李丹 易帅 张鑫磊 佟飞 孔明健
药物流行病学杂志2024,Vol.33Issue(4) :402-409.DOI:10.12173/j.issn.1005-0698.202401052

瑞马唑仑和右美托咪定对甲状腺手术全麻苏醒期呛咳抑制效果的比较

Comparison of the effects of remimazolam and dexmedetomidine on inhibiting cough during emergence from general anesthesia in patients undergoing thyroid surgery

李丹 1易帅 1张鑫磊 1佟飞 1孔明健1
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作者信息

  • 1. 徐州医科大学第二附属医院麻醉科(江苏徐州 221006)
  • 折叠

摘要

目的 比较瑞马唑仑和右美托咪定对甲状腺手术全麻苏醒期呛咳的抑制效果.方法 111例行甲状腺手术的患者随机分为3组,每组37例,在手术缝合时,分别给予:瑞马唑仑以0.1 mg·kg-1负荷量推注,以0.05 mg·kg-1·h-1速度泵注至拔管(A组);右美托咪定以0.5 μg·kg-1负荷输注10 min(B组);0.9%氯化钠注射液持续泵注至拔管(C组).比较各组患者苏醒期呛咳发生率、中重度呛咳发生率、苏醒时间、拔管时间、患者苏醒期镇静评分以及各组干预前后、拔管前后不同时点的心率、平均动脉压.结果 A组呛咳发生率(37.84%)显著低于B组(67.57%)和C组(91.89%),差异有统计学意义(两两比较,校正后均P<0.016 7);且A组中重度呛咳发生率(8.11%)低于B组(35.14%)和C组(67.57%),差异有统计学意义(校正后均P<0.001).B组苏醒时间及拔管时间明显大于A组、C组(校正后均P<0.001);在拔管及拔管后,B组的镇静评分较C组稍高(校正后分别P=0.002、P=0.007);药物干预后,与C组相比,A、B两组心率呈现不同程度的下降,不同药物与时间具有交互作用,且B组患者心率降低程度更大.结论 瑞马唑仑可抑制甲状腺全麻苏醒期呛咳的发生,降低呛咳严重程度.相比于右美托咪定,瑞马唑仑不延长苏醒时间及拔管时间,血流动力学平稳.

Abstract

Objective To compare the inhibitory effects of remimazolam and dexmedetomidine on cough during emergence from general anesthesia after thyroid surgery.Methods Patients with 111 cases of thyroid surgery were randomly divided into 3 groups,37 in each group.Group A was given a bolus of 0.1 mg·kg-1 and 0.05 mg·kg-1·h-1 remimazolam intravenous infusion until extubation,group B was given 0.5 μg·kg-1 of the dexmedetomidine over 10 minutes,and group C was given same dose of normal saline.The incidence of cough during emergence from general anesthesia,the moderate and severe cough,the recovery time and extubation time,the Ramsay Sedation Scale(RSS)score,and the heart rate(HR),and mean arterial pressure(MAP)at different time points before and after intervention and before and after extubation were recorded and compared.Results There were significant differences in the incidence of coughing among group A,B and C(37.84%vs.67.57%vs.91.89%,adjusted P<0.016 7,respectively).The incidence of moderate and severe cough was also lower in group A than in group B and C(8.11%vs.35.14%vs.67.57%,adjusted P<0.001).The recovery time and extubation time were longer in group B than those of group A and C(adjusted P<0.001).The RSS scores at the time of extubation and after extubation were higher in group B than in group A and C(adjusted P=0.002 and P=0.007,respectively).After intervention,compared with group C,the HR of group A and B decreased to different degree,and different drugs interacted with time,and the HR of group B patients decreased to a greater extent.Conclusion Remimazolam suppresses the occurrence and reduces the severity coughing during emergence from general anesthesia,and reduce the severity in patients treated with thyroid surgeries.Compared with dexmedetomidine,remimazolam did not prolong recovery time and extubation time,remaining more stable haemodynamics.

关键词

瑞马唑仑/右美托咪定/甲状腺手术/全麻苏醒期/呛咳

Key words

Remimazolam/Dexmedetomidine/Hyroid surgery/General anesthesia recovery period/Cough

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基金项目

徐州市卫生健康委科技项目(XWKYHT20230041)

出版年

2024
药物流行病学杂志
中国药学会 武汉医药(集团)股份有限公司

药物流行病学杂志

CSTPCD
影响因子:0.746
ISSN:1005-0698
参考文献量4
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