Effect comparison of dexmedetomidine and dexamethasone on suppressing sufentanil-induced cough during general anesthesia induction in patients with gynecological tumors / 肿瘤研究与临床

ABSTRACT

Objective:To investigate the efficacy and safety of dexmedetomidine and dexamethasone in inhibiting opioid-induced cough (OIC) during general anesthesia induction in patients with gynecological tumors.Methods:A total of 180 patients who were scheduled for elective gynecological tumor surgery under general anesthesia in Shanxi Provincial Cancer Hospital from March to November 2019 were selected. They were randomly divided into blank control group, dexmedetomidine group and dexamethasone group according to the random number table method, each group had 60 cases. Firstly, all patients had a 10-minute rest (T 0) after they entered the operate room. Treatment before general anesthesia inductiondexmedetomidine group was pumped dexmedetomidine 0.5 μg/kg (diluted to 10 ml with 0.9% NaCl injection) using an electronic infusion pump; dexamethasone group was injected intravenously dexamethasone 10 mg; blank control group was pumped with 10 ml 0.9% NaCl injection. The pumping was finished within 5 minutes, and the end time of pumping was denoted as T 1. Induction of general anesthesia was performed 5 minutes after the end of pumping firstly, sufentanil was given intravenously at 0.3 μg/kg, and the injection was finished within 5 seconds (T 2). Two minutes after sufentanil injection (T 3), cis-atracurium 0.3 mg/kg and propofol medium/long-chain injection 2 mg/kg were sequentially injected. Then preoxygenation, endotracheal intubation and mechanical ventilation were implemented in turn. One minute after intubation was recorded as T 4. The incidence and severity of cough in patients within T 2-T 3 of each group were recorded, as well as the incidence of tachycardia, bradycardia, hypertension, hypotension, respiratory depression and myotonia during T 1-T 4. Results:The incidence of OIC in the dexmedetomidine group (10.0%, 6/60) and dexamethasone group (8.3%, 5/60) was lower than that in the blank control group (33.3%, 20/60), and the difference among the three groups was statistically significant ( χ2 = 16.445, P < 0.01), while there was no significant difference in the incidence of OIC between the dexmedetomidine group and the dexamethasone group ( P > 0.05). The incidence of sinus bradycardia in the dexmedetomidine group (16.3%, 10/60) was higher than that in the blank control group (0, 0/60) and dexamethasone group (8.4%, 1/60), and the difference was statistically significant ( P < 0.05). Respiratory depression and myotonia did not occur in the three groups. Conclusions:Pretreatment with dexmedetomidine or intravenous dexamethasone before anesthesia induction can effectively reduce the incidence of OIC in patients with gynecological tumors, and there is no significant difference between the effects of the two drugs. The incidence of sinus bradycardia increases significantly after dexmedetomidine infusion.