Effects Of Different Doses Of Dexmedetomidine On Recovery Period Of Endoscopic Sinus Surgery Under General Anesthesia

Objective: The effects of different doses of dexmetomidine on hemodynamics,extubation quality,sedation and comfort in patients undergoing nasal endoscopic surgery under general anesthesia were observed by 10 min nasal drip before anesthesia induction,as well as the effects of stress reaction,cough reaction,postoperative sore throat,postoperative restlessness and other adverse reactions caused by extubation during the recovery period.To explore the appropriate dose of dexmedetomidine to improve the quality of patients undergoing nasal endoscopic surgery during awakening,and to provide a more safe and comfortable preanesthetic regimen for patients undergoing nasal endoscopic surgery under general anesthesia.Methods: Patients undergoing endoscopic sinus surgery under general anesthesia in the affiliated Hospital of Yan'an University from December2018 to December 2019 were randomly divided into four groups: low dose group(D1 group,0.25ug/kg),medium dose group(D2 group,0.5ug/kg),high dose group(D3 group,1ug/kg)and control group(group C,n = 30).Before anesthesia induction 10 min,D1 group,D2 group and D3 group were injected with dexmetomidine through bilateral nostrils,while group C was injected with normal saline through bilateral nostrils.After administration of 10 min,anesthesia induction began.The patients were recorded when entering the room(T1),before nasal dripping(T2),awakening(T3),extubation(T4),5min after extubation(T5),10 min after extubation(T6),heart rate(HR),mean arterial pressure(MAP),SpO2;recording operation time and extubation time,extubation quality score(T4),Rasmay sedation score and comfort score(BCSscore)at extubation 10min(T6).The adverse reactions during the recovery period were recorded.Results:1.There was no significant difference in gender composition,age,BMI and operation time among the four groups(P>0.05).2.Compared with T1,MAP was significantly increased in both the control group and the low-dose group at four time points of T3,T4,T5,T6(P<0.05).Compared with T1,MAP in the medium dose group decreased significantly at T3 and T6(P<0.05).Compared with T1,MAP in the high-dose group decreased significantly at T3,T5 and T6,(P<0.05).Compared with the control group and the low-dose group,there was a significant decrease in the medium-dose group and the high-dose group at T3~T6(P<0.05).3.Compared with T1,HR was significantly increased in the control group and the low-dose group at four time points of T3,T4,T5 and T6(P<0.05).Compared with T1,HR in the medium dose group decreased significantly at T6(P<0.05).Compared with T1,HR decreased significantly in the high-dose group T3,T4,T5,T6(P<0.05).Compared with the control group and the low-dose group,HR in the medium-dose group and the high-dose group decreased significantly at T3~T6(P<0.05).Compared with the medium-dose group,the high-dose group showed a significant decrease in HR at T3~T5(P<0.05).4.Compared with T1,SpO2 was decreased in the low-dose group of the control group at T4 and T5,and decreased in the high-dose group of the medium-dose group at T4(P<0.05);There was no significant difference in SpO2 between the four groups at different time points(P<0.05).5.Compared with the control group and the low-dose group,the quality score of extubation in the medium-dose group and the high-dose group was significantly reduced at T4(P<0.05).At T6,the comfort score of Ramsay sedation score was significantly increased in the medium-dose group and the high-dose group(P<0.05);Ramsay sedation score increased at T6 in the high-dose group compared to the medium-dosegroup(P<0.05);Extubation time was prolonged in the high-dose group compared with the control low-dose group and the medium-dose group(P<0.05).6.Compared with the control group and the low-dose group,the incidence of postoperative complications was lower in the medium-dose group and the high-dose dexmedetomidine group(P<0.05).Conclusion: 1.The intranasal dexmedetomidine of 0.5ug/kg or 1ug/kg to10 minute before induction of anesthesia both could significantly reduce the stress response caused by extubation in patients undergoing nasal endoscopic surgery.2.Moreover,intranasal dexmedetomidine of 0.5ug/kg could effectively reduce the incidence of adverse reactions such as cough and throat pain and restlessness during the recovery period,which is worth promoting in clinical practice.