Comparison Of The Effects Of Dexmedetomidine And Dexamethasone On Sufentanil-induced Cough During General Anesthesia Induction

Objective:OIC（opioid-induced cough）is frequent during the induction of anesthesia,Thus increasing the risk of patients undergoing general anesthesia.The purpose of this study was to compare the efficacy and safety of dexmedetomidine and dexamethasone in inhibiting OIC.Methods:A total of 180 patients were selected to undergo elective gynecological surgery under laparoscopic hysterectomy.They were randomly divided into 3 groups:Group C（blank control）,D₁（dexmedetomidine group）,D₂（dexamethasone group）.First,180patients were admitted to the room to rest,and this time was the starting point of timing（T₀）.Treatment before induction of general anesthesia:Group D₁will be given dexmedetomidine 0.5 ug/kg（diluted to 10 ml with 0.9%normal saline）intravenously by electronic infusion pump.Group C will receive 10ml of 0.9%normal saline with an electronic pump.The process will be within 5 minutes.The D₂group will be given dexamethasone 10 mg via peripheral intravenous access.5 minutes after the end of the pump is recorded as（T₁）.Then start anesthesia induction:Sufentanil was first given intravenously at 0.3ug/kg in 5s.End time recorded as（T₂）.After two minutes（T₃）,cis-atracurium 0.3mg/kg and propofol medium long chain injection 2mg/kg were injected sequentially.Then preoxygenation endotracheal intubation and mechanical ventilation were implemented in turn.1minute after intubation was recorded as（T₄）.The incidence and severity of cough in patients with T₂to T₃were recorded,and adverse events occurring between T₁and T₄such as hypertension,hypotension,arrhythmia,respiratory depression and myotonia were also recorded.Results:The OIC incidence of dexmedetomidine group（D₁group）and dexamethasone group（D₂group）was significantly lower than that of the blank control group（10%in Group D₁,8.3%in group D₂,and 33.3%in group C,P<0.0167）.While there was no significant difference in OIC incidence between D₁and D₂groups.Meanwhile,the incidence of sinus bradycardia in group D₁was significantly higher than that in group C and Group D₂.（Group D₁16.3%,Group D₂8.4%,Group C5.7%）.Respiratory depression and myotonia did not occur in the 3 groups.Conclusion:Dexmedetomidine 0.5ug/kg or intravenous dexamethasone 10mg pretreatment before induction of anesthesia can effectively reduce the incidence of OIC,and there is no significant difference in the inhibitory effect of the two drugs on the occurrence of OIC.The incidence of sinus bradycardia was significantly increased after dexmedetomidine infusion.Dexamethasone is more stable than dexmedetomidine for OIC prevention.