Objective  To compare the inhibitory effects of remimazolam and dexmedetomidine on cough during emergence from general anesthesia after thyroid surgery.

Methods  Patients with 111 cases of thyroid surgery were randomly divided into 3 groups, 37 in each group. Group A was given a bolus of 0.1 mg·kg^-1 and 0.05 mg·kg^-1·h^-1 remimazolam intravenous infusion until extubation, group B was given 0.5 µg·kg^-1 of the dexmedetomidine over 10 minutes, and group C was given same dose of normal saline. The incidence of cough during emergence from general anesthesia, the moderate and severe cough, the recovery time and extubation time, the Ramsay Sedation Scale (RSS) score, and the heart rate (HR), and mean arterial pressure (MAP) at different time points before and after intervention and before and after extubation were recorded and compared.

Results  There were significant differences in the incidence of coughing among group A, B and C (37.84% vs. 67.57% vs. 91.89%, adjusted P<0.016 7, respectively). The incidence of moderate and severe cough was also lower in group A than in group B and C (8.11% vs. 35.14% vs. 67.57%, adjusted P<0.001). The recovery time and extubation time were longer in group B than those of group A and C (adjusted P<0.001). The RSS scores at the time of extubation and after extubation were higher in group B than in group A and C (adjusted P=0.002 and P=0.007, respectively). After intervention, compared with group C, the HR of group A and B decreased to different degree, and different drugs interacted with time, and the HR of group B patients decreased to a greater extent.

Conclusion  Remimazolam suppresses the occurrence and reduces the severity coughing during emergence from general anesthesia, and reduce the severity in patients treated with thyroid surgeries. Compared with dexmedetomidine, remimazolam did not prolong recovery time and extubation time, remaining more stable haemodynamics.

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