Department of Anesthesiology, The First Affiliated Hospital, Anhui Medical University, Hefei, 230022, China.
Department of Anesthesiology, The Anqing Affiliated Hospital, Anhui Medical University, Anqing, 246003, China.
BMC Anesthesiol. 2019 May 4;19(1):66. doi: 10.1186/s12871-019-0739-1.
Intravenous lidocaine and dexmedetomidine treatments have been proposed as methods for inhibiting cough. We compared the efficacy of intravenous lidocaine and dexmedetomidine treatments on inhibiting cough during the tracheal extubation period after thyroid surgery.
One hundred eighty patients undergoing thyroid surgeries were randomly allocated to the LIDO group (received lidocaine 1.5 mg/kg loading, 1.5 mg/kg/h infusion), the DEX group (received dexmedetomidine 0.5 μg/kg loading, 0.4 μg/kg/h infusion) and the CON group (received saline), with 60 cases in each group. The primary outcomes of cough were recorded. Secondary outcomes included hemodynamic variables, awareness time, volume of drainage, the postoperative visual analogue scale and adverse effects were recorded.
The incidence of cough were significantly lower in the LIDO group (28.3%) and the DEX group (31.7%) than that in the CON group (66.7%) (P = 0.000). Additionally, both moderate and severe cough were significantly lower in the LIDO group (13.3%) and the DEX group (13.4%) than these in the CON group (43.4%) (P < 0.05). Compared with the two treatment groups, both mean arterial blood pressure and heart rate were significantly increased in the CON group during tracheal extubation (P < 0.05). Compared with the CON group, the volume of drainage was significantly reduced in the two treatment groups within 48 h after surgery (P < 0.05). compared with the CON group, the postoperative visual analogue scale was significantly lower in groups LIDO and DEX after surgery(P < 0.05). Compared with the LIDO group and the CON group, the time to awareness was longer in the DEX group (P < 0.05). In the DEX group, bradycardia was noted in 35 patients, while no bradycardia was noted in LIDO group and CON group.
Compared with intravenous infusions of normal saline, both lidocaine and dexmedetomidine had equal effectiveness in attenuating cough and hemodynamic changes during the tracheal extubation period after thyroid surgery, and both of these treatments were able to reduce the volume of postoperative bleeding and provide better analgesic effect after surgery. But intravenous infusions of dexmedetomidine resulted in bradycardia and delayed the time to awareness when compared with lidocaine and normal saline.
ChiCTR1800017482 . (Prospective registered). Initial registration date was 01/08/2018.
静脉内利多卡因和右美托咪定的治疗已被提议作为抑制咳嗽的方法。我们比较了静脉内利多卡因和右美托咪定治疗在甲状腺手术后气管拔管期间抑制咳嗽的效果。
180 例甲状腺手术患者随机分为利多卡因组（接受利多卡因 1.5mg/kg 负荷量，1.5mg/kg/h 输注）、右美托咪定组（接受右美托咪定 0.5μg/kg 负荷量，0.4μg/kg/h 输注）和对照组（接受生理盐水），每组 60 例。记录咳嗽的主要结果。次要结果包括血流动力学变量、意识时间、引流体积、术后视觉模拟评分和不良反应。
利多卡因组（28.3%）和右美托咪定组（31.7%）的咳嗽发生率明显低于对照组（66.7%）（P=0.000）。此外，利多卡因组（13.3%）和右美托咪定组（13.4%）的中度和重度咳嗽发生率明显低于对照组（43.4%）（P<0.05）。与两组治疗组相比，对照组在气管拔管期间平均动脉血压和心率均明显升高（P<0.05）。与对照组相比，两组治疗组术后 48 小时内引流体积均明显减少（P<0.05）。与对照组相比，利多卡因组和右美托咪定组术后视觉模拟评分明显降低（P<0.05）。与利多卡因组和对照组相比，右美托咪定组的意识恢复时间较长（P<0.05）。右美托咪定组 35 例出现心动过缓，而利多卡因组和对照组均无心动过缓。
与静脉输注生理盐水相比，利多卡因和右美托咪定在甲状腺手术后气管拔管期间抑制咳嗽和血流动力学变化方面同样有效，且两种治疗方法均能减少术后出血，并在术后提供更好的镇痛效果。但与利多卡因和生理盐水相比，静脉输注右美托咪定可导致心动过缓，并延迟意识恢复时间。
ChiCTR1800017482（前瞻性注册）。初始注册日期为 2018 年 1 月 8 日。
