| Object Surgery and concurrent psychological stressors can lead to a series of stress response,resulting in nervous,endocrine,and inflammatory changes.Postoperative recovery means that the body is getting back to ?normal? without stress response.Colorectal cancer is a high incidence of malignant tumor,which main treatment is in laparoscopic.How to promote this kind of patients with postoperative recovery to shorter hospital stay,reduce cost and increase medical resources reasonable allocation is an important subject.Dexmedetomidine has many characteristics,such as sedation,analgesia,anti-anxiety.In our study,we took laparoscopic colorectal cancer surgery for example to discusses the application of dexmedetomidine during anesthesia and the impact on the postoperative Fatigue severity score and Qo R-15 score.Methods A total of 69 patients were selected from the second hospital of Chongqing Medical University from April to December 2017,divided into the experimental group(34 cases)and the control group(35 cases)randomly.The experimental group was given 0.5 ug/kg dexmedetomidine 15 min before anesthesia induction;after intubation,intraoperative continuous pump 0.2 ug/kg/h to the skin began to sutured.The control group was given the same dose of saline at the same time.The questionnaire was conducted on the first day before surgery(Pre),the first day after surgery(Day1),the second day after surgery(Day2)and the third day after surgery(Day3),including Qo R-15 scale,fatigue severity score(FSS),VAS score and the length of hospitalization after surgery.The heart rate(HR)and mean arterial pressure(MAP)were both recorded respectively at the first 15 min before anesthesia induction(T0),intubation immediately(T1),cutting the skin(T2),pneumoperitoneum(T3),extubation(T4),leaving the operating room(T5).Record the recovery time,the incidence rate of bucking and agitation and the Ramsay sedation score before back to the ward.Record the number of analgesia pump compression in 24 and 48 hours,the postoperative shiver,nausea and vomiting,additional analgesic use.Results1 No significant difference between two groups in the baseline characters and perioperative parameters(P>0.05).2 The Qo R-15 scale score,FSS score and the length of hospitalization after surgery: through two factor analysis of repeated measurement,two groups in Qo R-15 scale,FSS score has interaction,the differences were significant(P<0.05).Comparison within group: two groups' Qo R-15 scores within three days after surgery was lower than preoperative,the Day2 and Day3 score was higher than the Day1,the Day3 was higher than the Day2.The FSS score of both groups was higher in the three days after surgery,the scored of Day2 and Day3 was lower than Day1,Day3 was lower than Day2.Comparison between groups: in preoperative the score about two scales are similar,the experimental group scored Qo R-15 was higher and FSS was lower than control group during three days in postoperation,the Qo R-15 at Day2 and FSS score at Day3 were obvious(P<0.05).The length of hospitalization after surgery in the control group was 1.43 days longer than the test group(95% CI: 0.28~2.58).3 The HR and MAP during anesthesia: after two factor analysis of repeated measurement,there was no interaction of two groups with treatment and time,so we need to analysis the main effect factors.The HR 4.178 lower than the control group(95%CI:1.818 ~ 6.538).And the MAP of experimental group was 4.356 mm Hg lower than the control group(95%CI:1.094 ~ 7.617).In the control group,the HR was higher at T1 and T4 than T0(P<0.05);the change of HR in the test group was not obvious(P>0.05).In the control group,the MAP at T1,T3,T4 was higher than T0(P<0.05).In the test group,the MAP at T4 was higher than T0(P<0.05).4 Observation data during recovery from general anesthesia: there was no significant difference in waking time between two groups(P>0.05).The incidence of cough(13.3%)in the test group was significantly lower than that in control group(70%).The incidence of reactivity in the control group was 23.3%,which was higher than 10% in the experimental group,but the difference was meaningless(P>0.05).Ramsay score was higher in the test group(P<0.05).5 Postoperative adverse events:(1)the VAS score: interaction between two groups with different treatment and time(P<0.05).Comparison within group: The score of VAS in postoperative three days was higher than Pre;the score at Day2 and Day3 was lower than Day1;the score at Day3 was lower than Day2,we can conclude that the VAS score decreased as time goes on.Comparison between groups: at Day1,the score was no significant difference(P>0.05).But the scores at Day2 and Day3 in experimental group were lower than control group(P<0.05).(2)The number of analgesic pump compression was lower in the test group in 24 and 48 hours after surgery(P<0.05).And the analgesic drug supplementation after surgery was lower than the control group(P<0.05).(3)The incidence of postoperative shiver and PONV were lower in the experimental group(P<0.05).Conclusion1 In colorectal cancer surgery,DEX infusion can increase Qo R-15 scores,reduce FSS scores,shorten the length of hospital stay,and thus improve the postoperative recovery.2 In colorectal cancer surgery,DEX can inhibit the heart rate and blood pressure during intubation and extubation,reduce hemodynamic fluctuations,and provide stable anesthesia.3 In colorectal cancer surgery,DEX can reduce the incidence of cough in the convalescence period,which is conducive to the recovery of anesthesia.4 In colorectal cancer surgery,DEX can reduce the postoperative side effects,such as pain,nausea,vomiting,and shiver,which is conducive to postoperative recovery. |
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