The Effect Of Continuous Infusion Of Remifentanil On The Cough-preventing In Female Thyroid Patients During Anesthetic Emergence

Objective:To investigate the effect of continuous infusion of remifentanil on the cough-preventing in female thyroid patients during anesthetic emergence.Methods:A total of 60 female patients who underwent thyroid surgery in the China-Japan Union Hospital of Jilin University were selected,aged from20 to 65 years old,ASA class Ⅰ-Ⅱ.According to the method of random number table,they were divided into group A,group B and group C.All patients were induced with intravenous injection of sufentanil 0.4μg/kg,propofol 1.0mg/kg,cisatracurium 0.05mg/kg,etomidate 0.2mg/kg.Anesthesia maintenance:continuous inhalation of 1.5%-3%sevoflurane concentration,continuous infusion of remifentanil,adjustment of sevoflurane and remifentanil concentration according to surgical stimulation,blood pressure,heart rate and BIS,and closure of sevoflurane volatilization tank before suture skin.At the end of the operation,the remifentanil was adjusted to different doses until the end of extubation.Group A: 0.02μg /(kg·min);group B: 0.05μ g /(kg ·min);group C: 0.07μg /(kg·min).When the BIS value of the patient is more than 80,open their eyes and nod and shake according to the instructions,and extubation when tidal volume ≥ 5ml/kg.Results:There was no significant difference in general data(including name,age and BMI)among the three groups(P>0.05).There was significant difference in the score of cough degree during extubation among the three groups(P<0.05).There was significant difference between group A and group B and C(P<0.05)at grade1 and grade3,but there was no significant difference between group B and C(P>0.05).There was no significant difference among the groups at grade 2(P>0.05).There was significant difference in extubation time among the three groups(P<0.05).Comparison of mean arterial pressure among the three groups:there was significant difference between T2 and other time points in group A(P<0.05),there was no significant difference among other time points(P>0.05),there was significant difference between T2 and other time points in group B(P<0.05),and there was no significant difference among other time points(P>0.05).There was significant difference between T2 and other time points in group C(P<0.05),and there was significant difference between T1 and T3(P<0.05),but there was no significant difference among other time points(P>0.05).The change trend of mean arterial pressure with time was the same among the three groups,and there was no interaction.Comparison of heart rate among the three groups: there was no significant difference between T1 and T3,T5 in group A(P>0.05),and there was no significant difference between T3 and T4,T5(P>0.05),and there was no significant difference between T4 and T5(P>0.05).There were significant differences among other time points(P<0.05).In group B,there was no significant difference between T1 and T3,T4,T5(P>0.05),and there was no significant difference between T3 and T5(P>0.05),and there was no significant difference between T4 and T5(P>0.05).There were significant differences among other time points(P<0.05).There was no significant difference between T1 and T3,T5 in group C(P>0.05),and there was no significant difference between T3 and T4,T5(P>0.05),and there was no significant difference between T4 and T5(P>0.05).There were significant differences among other time points(P<0.05).The change trend of heart rate of the three groups was different with time,and there was interaction.Comparison of blood oxygen saturation among the three groups: at T4,there was significant difference between group C and group A and B(P<0.05),but there was no significant difference between group A and group B(P>0.05).At T5,there was significant difference between group C and group A and B(P<0.05),but there was no significant difference between group A and group B(P>0.05).Intra-group comparison: there was no significant difference between T2 and T3 in group C(P>0.05),and there was also no significant difference between T4 and T5(P>0.05),but there were significant differences among other time points(P<0.05).The change trend of blood oxygen saturation in the three groups was different with time,and there was interaction.There was no significant difference in restlessness score among the three groups(P>0.05).There was significant difference in sedation score among the three groups(P<0.05).There was significant difference between group C and group A and B(P<0.05),but there was no significant difference between group A and group B(P>0.05).Conclusion:Continuous infusion of remifentanil 0.05μg/(kg·min)during the recovery period of general anesthesia in female thyroid patients is beneficial to inhibit the occurrence of cough and does not affect the quality of recovery.