| Objective:This study through 30 min before in elderly patients with gastric cancer surgery anesthesia induction will different doses of the right beautiful mi sizing drip into the nasal cavity,observe its on stage in elderly patients with gastric cancer surgery intubation and extubation hemodynamic,postoperative revive quality and the effect of early postoperative cognitive dysfunction,to explore suitable for elderly patients with right beauty holds the mi set the most safe and effective dose,intranasal for elderly patients with gastric cancer surgery more safe and comfortable reference before anesthesia regimen.Methods:A total of 80 patients with gastric cancer who were to undergo radical gastrectomy under general anesthesia in the Affiliated Hospital of Yan ’an University from December 2019 to December 2020 were randomly divided into 4 groups with 20 patients in each group: control group(group C),low-dose group(D1)0.25μg/kg,mid-dose group(D2)0.5 μg/kg,and high-dose group(D3)1.0μg/kg,respectively.Dexmedetomidine or 0.9% normal saline were administered intranasally in groups 30 min before induction of anesthesia.MMSE scores,DEX before nasal drip(T1),before intubation(T2),immediately after intubation(T3),5min after intubation(T4),before extubation(T5),immediately after extubation(T6),5min after extubation(T7),Ricer sedation-agitation score,postoperative extubation quality score,and total opioid use were recorded 1d before surgery,1d,3d and 7d after surgery.Results:1.There was no statistical significance in the basic data(gender,age,BMI,operation time)among the four groups(P>0.05).2.Compared with T1,MAP in all four groups was decreased at T2,and significantly increased in group C and D1 at T3 and T4,with statistical significance(P<0.05).Compared with T5,MAP in group C and D1 was significantly increased at T3 and T4,with statistical significance(P<0.05).Compared with group C,MAP in group D3 was significantly increased at moments T2-T4,and was significantly decreased at moments T6 and T7 in groups D2 and D3,with statistical significance(P<0.05).3.Compared with the T1,T2 time four groups of patients HR are lower,T4 moment HR group C with D1 group was obviously lower,the difference was statistically significant(P < 0.05),compared with the time T2,T3 moment HR group C with D1 group was obviously higher,the difference was statistically significant(P < 0.05),compared with T5 moment,C group and D1 in T6,T7 has increased significantly,the difference was statistically significant(P < 0.05);Compared with group C,HR in groups D2 and D3 was significantly decreased at T3,with statistical significance(P<0.05).4.Compared with group C,the amount of remifentanil in group D3 was significantly decreased,with statistical significance(P<0.05),but there was no statistical significance in group C,group D1 and group D2(P>0.05).There was no statistical significance in the amount of sufentanil used in the four groups(P>0.05).5.Compared with group C,extubation quality scores of patients in groups D2 and D3 were decreased,while Ricker sedation-agitation scores of patients in groups D1,D2 and D3 were decreased,the difference was statistically significant(P<0.05).Compared with D1 group,extubation quality score and Ricker sedation-agitation score of patients in D2 group and D3 group were decreased,with statistical significance(P<0.05).There were no significant differences in extubation quality score and Ricker sedation-restlessness score between D2 group and D3 group(P>0.05).6.Compared with group C,D1 and D2 groups’ MMES score on the 3rd and 7th day after surgery was less than 27 points,with statistical significance(P<0.05);Compared with the D1 group,the MMES scores of patients in the D1 and D2 groups on the 3rd and 7th day after surgery were less than 27 points,with statistical significance(P<0.05).Conclusion:Dexmedetomidine nasal drops 30 min before general anesthesia induction can stabilize hemodynamics during intubation and extubation,reduce the dosage of opioids,effectively improve the quality of postoperative recovery period,and improve the occurrence of postoperative cognitive dysfunction.1.0μg/kg Dexmedetomidine nasal drops have the best effect in elderly patients with gastric cancer surgery,which is worthy of reference in clinical medication. |
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