Effects Of Different Loading Doses Of Dexmedetomidine On Sedation During Awake Intubation In Elderly Patients

Objective:In this study,the effect of dexmedetomidine at different loading doses on awake tracheal intubation in elderly patients was observed by preoperative injection intravenous infusion of different loading dose of dexmedetomidine.Discuss the reasonable dosage,which patients were treated with awke intubation,so as to provide reference for the clinical application of the drug.Methods:Forty-five patients undergoing elective awake intubation anesthesia were randomly divided into three groups,group A?0.5?g/kg dexmedetomidine?,group B?0.75?g/kg dexmedetomidine?and group C?1?g/kg dexmedetomidine?,with 15 patients in each group,and finish infusing them at a constant speed within 10min.The patients were instructed to cooperate with tracheal intubation after complete surface anesthesia and intratracheal anesthesia with 1%tetracaine.Blood pressure,heart rate,arterial oxygen saturation were recorded after going inside the operating room?T0?,before endotracheal intubation?T1?,during endotrachel intubation?T2?,one minute after endotracheal intubation?T3?,five minutes after endotraceal intubation?T4?,and plasma concentrations of norepinephrine and epinephrine were recorded at T0,T2,T4.The usage of atropine,ephedrine,and nitroglycerin were recorded,and the adverse reaction was observed in the course.Results:Arterial oxygen saturation at T1 in group C were lower than those in group A?P<0.05?,heart rate in group B and C were also lower than group A?P<0.05?.HR at T2 in group A were significantly higher than those in group B and C?P<0.05?.SPO₂ at T2 in group C were lower than those in group A and B?P<0.05?.SBP and HR at T3 in group C were significantly lower than those in group A and group B?P<0.05?.HR at T3 in group B were lower than those in group A?P<0.05?.With the increase of dexmedetomidine loading dose concentration,the incidence of adverse reactions such as bucking,restlessness,and terrible memories decreased?P<0.05?.The incidence of bucking at the course of trachea intubation in group A was higher than in group B and C,and the incidence of bradycardia in group C was significantly higher than group A?P<0.05?.The plasma concentrations of epinephrine at T2 in group A were significantly higher than those in other groups?P<0.05?,and norepinephrine at T2 in group C were lower than group A?P<0.05?.Ramsay sedation scales at T1 in group B and C were higher than those in group A?P<0.05?.Conclusion:Infusing dexmedetomidine 0.75?g/kg could be safely and effectively used for sedation during awake intubation in elderly patients with lighter cardiovascular response and less side effects.