Effect Of Dexmedetomidine On Patient-controlled Analgesia With Sufentanil After Radical Gastrectomy In Patients With High Nicotine Dependence

Objective:To investigate the effect of dexmedetomidine on patient-controlled intravenous analgesia with sufentanil after radical gastrectomy in patients with high nicotine dependence.Methods:Sixty-four high-dependent nicotine patients undergoing elective radical gastrectomy were randomly divided into a control group?C group,n=34?and dexmedetomidine group?D group,n=30?.Both groups were treated with general anesthesia.In Group D,the patient received a loading dose of dexmedetomidine 0.5?g/kg for 10 min before the end of surgery,and Group C received an equal 0.9%sodium chloride injection.All patients were treated with intravenously controlled analgesia.PCIA preparation method for C group patients is100?g sufentanil citrate injection+0.9%sodium chloride injection Configured into100ml solution;PCIA preparation method for D group patients is 100?g sufentanil citrate injection+100?g dexmedetomidine hydrochloride injection+0.9%sodium chloride injection configured as 100ml solution.The PCIA parameter setting is based on the weight of the patient.Background infusion volume?ml?per hour=0.04 x body weight?kg?,Single infusion volume?ml?=0.04×body weight?kg?,locking time 15 min,1h limited 15 ml.After the patients returning to the ward,We should record the NRS scores,sufentanil injection consumption,MAP,HR and SpO₂ of 0h?T₀?,4h?T₁?,8h?T₂?,12h?T₃?,16h?T₄?,20h?T₅?,and 24h?T₆?respectively.At last,We recorded the analgesic remedy,is there nausea and vomiting,is there pruritus,and QoR-40 total score.Results:The NRS scores of C group and D group were all different in T₀-T₆.The NRS scores of C group was higher than D group,and the difference was statistically significant?P<0.05?.The consumption of sufentanil in C group and D group were all different in T₀-T₆.The consumption of sufentanil in C group was higher than D group,the difference was statistically significant?P<0.05?.This shows that dexmedetomidine has an analgesic effect with sufentanil and can reduce the amount of sufentanil.There was no significant difference in MAP,HR,SpO₂ between the two groups in T₀-T₆?P>0.05?,indicating that low-dose,slow intravenous infusion of dexmedetomidine will not affect hemodynamics,nor will it affect the respiratory function.Features.The QoR-40 score in group D was higher than that in group C,indicating that the combination of low-dose dexmedetomidine for postoperative patient-controlled intravenous analgesia has higher comfort.Conclusion:1.For the nicotine withdrawal symptoms of smoking cessation before surgery,postoperative combined use of low-dose dexmedetomidine can synergize with the analgesic effect of sufentanil,reduce the amount of opioids,and reduce the incidence rate of postoperative untoward effect such as nausea and vomiting,pruritus.2.Postoperative slowing intravenous injection of low-dose dexmedetomidine will not affect the patient's hemodynamics,it also will not appear respiratory depr-ession,and it can improve the postoperative comfort of patients,to provide more comfortable medical treatment for smokers.So it is worthy of clinical application.