Effect Of Intranasal Dexmedetomidine On Reducing Intraocular Pressure In Patients Undergoing Laparoscopic Radical Gynecological Cancer Surgery

Objective:To investigate the effect of intranasal Dexmedetomidine on intraocular pressure in patients undergoing laparoscopic radical gynecological cancer surgery.Methods:According to inclusion and exclusion criteria,80 cases schduled for laparoscopic gynecological cancer radical surgery patients,aged 40-65 years old,BMI 20-25 kg/m2,falling into ASA physical statusⅠorⅡcatagory,were equally and randomly assigned into A,B,C and D,each group include 20 cases.Groups A,B and C were diluted with Dexmedetomidine 0.6μg/kg,0.8μg/kg and 1.0μg/kg respectively into 1 ml nasal drops,each nostril 0.5 ml.And the control group D was given normal saline 1 ml nasal drops,each nostril 0.5 ml.After general anesthesia,tracheal intubation and radial artery puncture were performed.Then laparoscopic radical cancer surgery was performed.After the operation,the patient was set to the Postanesthesia care uint（PACU）.After waking up,the patient was extubated to the ward after reaching the standard of leaving PACU.5 min before the endotracheal intubation（T₁）,5 min after endotracheal intubation（T₂）,5 min after pneumoperitoneum（T₃）,30 min after pneumoperitoneum（T₄）,60 min after pneumoperitoneum（T₅）,120 min after pneumoperitoneum（T₆）,180 min after pneumoperitoneum（T₇）,10 min before the end of pneumoperitoneum（T₈）,at these time points,measuring patients’eyes intraocular pressure,blood pressure and heart rate.And record the patient general condition,include age,body mass index and ASA physical status,and dosage of propofol,rocuronium use,total liquid input,and time of operation,anesthesia,wake up and extubation.Results:（1）There was no significant difference in age,BMI and ASA grade among the four groups（P>0.05）;（2）There was no significant difference in the total use of propofol and rocuronium and the total liquid infusion volume among the four groups（P>0.05）;There was no significant difference in operation time,anesthesia time,awakening time and extubation time among the four groups（P>0.05）;（3）Comparison of SBP and DBP:There was no difference in SBP and DBP between groups A,B,C and D（P>0.05）;（4）Comparison of the heart rate:Compared with group D,the heart rate of group A,B and C had significant difference at T₂,T₃,T₄,T₅,T₆,T₇ and T₈ time points（P<0.05）;Compared with group A,there was significant difference in heart rate between group B and group C at T₂,T₃,T₄,T₅,T₆,T₇ and T₈ time points（P<0.05）;Compared with group B,the heart rate of group C was significantly different at T₂,T₃,T₄,T₅,T₆,T₇ and T₈ time points（P<0.05）;（5）Comparison of the IOP:There was no significant difference in binocular intraocular pressure between T₁ time point and T₂ time point in the four groups（P>0.05）;Compared with group D,the intraocular pressure in groups A,B and C was significantly lower than that in group D at T₃,T₄,T₅,T₆,T₇ and T₈ time points（P<0.05）;The intraocular pressure in groups A,B,C and D was statistically significant at each time point after pneumoperitoneum compared with T₁ and T₂ time points（P<0.05）;Compared with group A,the binocular intraocular pressure of group B and C at T₆,T₇ and T₈ time points were significantly lower than that of group A（P<0.05）;Compared with group B,there was no significant difference in binocular intraocular pressure in group C at T₆,T₇ and T₈ time points（P>0.05）.Conclusion:Dexmedetomidine administrated intransally can reduce intraocular pressure,but the effect does not continuous increase with the increasing does,and the effect on heart rate will be increased,increase the incidence of sinus bradycardia.0.8μg/kg intransal Dexmedetomidine is an approprite does,which is safe and effective with less adverse reactions.