Effects Of Intranasal Dexmedetomidine Before The End Of Operation On The Recovery Quality Of Orthopedic Surgery Under General Anesthesia

Background and objective:With the development of society and the improvement of medical level,doctors are not only curing diseases for patients,but also providing patients with comfortable medical experience.For patients undergoing general anesthesia,comfortable medicine requires a safe and comfortable anesthesia process provided by anesthesiologists.Anesthesia recovery is one of the most important stages in general anesthesia.In this study,we observed the effects of nasal drip with different doses of Dexmedetomidine（DEX）30min before the end of surgery on the quality of recovery and hemodynamic indicators in patients with orthopedic general anesthesia.To explore the safety and efficacy of dexmedetomidine nasal drops,and to provide more evidence for the non-intravenous administration of dexmedetomidine.Objects and methods:A total of 90 patients with open reduction and internal fixation for fracture under general anesthesia in China-japan Alliance Hospital of Jilin University from December 2020 to December 2021 were selected.According to the nasal drip dose of dexmedetomidine,these 90 patients were divided into control group（GROUP C）,1.0μg/kg（group D1）and 1.5μg/kg（group D2）.In group D1 and GROUP D2,0.5 m L dexmedetomide diluted to 1m L was dropped into each side of both nostrils 30 min before the end of surgery,and the drops were finished within 1min.The control group（group C）received drops of the same amount of normal saline in the same manner.Records of the patient’s general condition respectively,record the house（T0）,and patients with nasal drops before（T1）,10 min after intranasal（T2）,（T3）when they wake up.When the tube drawing（T4）,5 min after extubation（T5）,mean arterial pressure（MAP）and heart rate（HR）,the awakening time（end of the surgery to awakening）were observed,extubation time（awakening to the tube drawing）,Choke reaction and agitation were observed during extubation,and corresponding scores were given.The occurrence and degree of adverse reactions were recorded.Results:1.There was no statistical difference in general data among the three groups（P > 0.05）.2.There were no significant differences in the time of awakening and extubation among the three groups（P > 0.05）;3.The cough score of group C during extubation was higher than that of GROUP D1 and GROUP D2,with statistical significance（P < 0.05）;4.Ramsay town score of group C 5min after extubation was lower than that of group D1 and group D2,the difference was statistically significant（P < 0.05）;5.There were no significant differences in MAP and HR between T1 group and T2 group（P > 0.05）;At T3,T4 and T5,the MAP and HR of D1 and D2 groups were lower than those of C group,the differences were statistically significant（P < 0.05）,and the MAP and HR of D2 group were lower than those of D1 group at T4（P < 0.05）.ConclusionBefore the end of the operation with 1.5μg/kg dose of dexmedetomide nasal drops after the patient anesthesia recovery sedation effect is better,can make the patient in the recovery period and extubation to maintain a more stable hemodynamic profile,cough and agitation probability is lower,and no mental and motor system recovery delay.It improves the quality of anesthesia recovery and is worthy of further clinical application and research.