The Effect Of Different Doses Of Dexmedetomidine Combined With Lidocaine On The Rehabilitation Of Endoscopic Surgery

Objective: to observe the effects of different doses of dexmedetomidine combined with lidocaine on perioperative anesthetic dosage and postoperative recovery.Methods: 120 cases of gynecologic endoscopy surgery patients,aged 18 to 65 years,height 150 to 170 cm,BMI(18-25)Kg / m2,ASA?-? grade,were divided into four groups(n = 30).Group L: intravenous infusion of the same amount of normal saline(15 minutes),followed by infusion of lidocaine at 1.5mg/Kg/h after intubation,until the end of the operation.Group D: intravenous infusion of the same amount of normal saline(15 min),followed by dexmedetomidine 0.4 g/Kg/h after intubation,until the end of the operation.D+L group: intravenous infusion of the same amount of normal saline(15 min),followed by dexmedetomidine 0.4 g/Kg/h and lidocaine 1.5mg/Kg/h after intubation,until the end of the operation.DD+L group: intravenous infusion of dexmedetomidine at a loading dose of 1 g/Kg(15min),followed by intravenous infusion of dexmedetomidine at 0.4 g/Kg/h and lidocaine at 1.5mg/Kg/h,until the end of the operation.The amount of opioid,propofol,postoperative recovery assessment,PACU sedation,analgesia score,48 h VAS score after operation,HR,MAP,and incidence of adverse reactions before and after extubation were recorded.Results: compared with the consumption of remifentanil,the consumption of remifentanil in the combination of dexmedetomidine and lidocaine was reduced,and the effect of adding dexmedetomidine was more obvious in the experimental group.The consumption of remifentanil: D group,l group > DL group > DDL group.Comparing the consumption of propofol,the consumption of propofol in all the groups using dexmedetomidine(Group D)was lower than that in the group not using dexmedetomidine(group L),and the load group(DDL)was also better than that in the group not using load(Group DL).The analgesic effect of dexmedetomidine combined with lidocaine was better than that of the single use,and the extubation reaction was reduced,and the restlessness score in the wake-up period was reduced,but the effect was more significant after adding dexmedetomidine load(1 ? g / Kg),and there was statistical significance,but there was almost no statistical difference for the recovery time of patients(P > 0.05).Compared with group D,group l had a better recovery of gastrointestinal function and a lowerincidence of PONV after operation.The effect of adding dextromethorphan in the study was further enhanced.However,the clinical incidence of bradycardia and hypotension in DDL group was significantly higher than that in other groups(P < 0.05).Conclusion:1.Dexmedetomidine combined with lidocaine can reduce the consumption of opioids and sedatives during the operation,reduce the adverse reactions during the perioperative period,and is conducive to postoperative rehabilitation.2.Dexmedetomidine combined with lidocaine was better than dexmedetomidine(1 ? g /Kg),but the incidence of bradycardia and hypotension was significantly increased.