Comparison Of Remifentanil With Dexmedetomidine In Inhibiting Coughing And Hemodynamics Instability During Extubation From General Anaesthesia In Patients Undergoing Thyroid Surgery

Objective:To compare the effects of continuous intravenous infusion of remifentanil(REM)and dexmedetomidine(DEX)on the inhibition of cough response and hemodynamic instability during extubation from the general anesthesia.Methods:Ninety patients undergoing general anesthesia for radical thyroidectomy were randomly and divided into three groups.They are control group N(n=30),remifentanil group R(n=30),and dexmede-tomidine group D(n=30).Anesthesia was maintained by continuous intravenous infusion of 2% propofol and Sevoflurane inhalation.In group R,remifentanil continued to be pumped to the end of extubation;in group D,dexmedetomidine pumped to the end of extubation.The mean arterial pressure(MBP)and heart rate(HR)of the three groups' patients before the surgery ? the end of surgery ? the moment immediately removal of the tracheal tube and the 5th ?10th and the 30 th minute after the extubation were recorded.The cough scores during extubation were recorded,and the time from the end of the procedure to the time of the tracheal catheter was withdrawn,and the duration of stay in the PACU.Results:A total of 90 patients were included in the statistical analysis.There were no significant differences in age,gender,BMI,operative time,and anesthesia time between the three groups.During extubation,the proportion of people with cough score ? 2 was significantly higher in group R(72.3%)and group D(76.7%)than group N(43.3%);at the moment immediately removal of the tracheal tube,MBP in group R and D was significantly lower than group N(P<0.05);HR in group R and group D were lower than group N(P<0.05)too.The PACU residence time of group D was significantly higher than that of group N and group R.Conclusions:During the general anesthesia recovery period,remifentanil and dexmedetomidine were effective in inhibiting cough response and agitation during resuscitation;both were equally effective in stabilizing hemodynamics;remifentanil group in reducing PACU residence time has its advantages;there is no obvious respiratory inhibition after extubation,and the sedative effect of dexmedetomidine is greater than that of remifentanil after extubation.