Effects Of Dexmedetomidine On Anesthetic Effect And Post-anesthesia Recovery In Patients Undergoing Supratentorial Tumor Surgery

Objective:To observe the effects of dexmedetomidine assists in general anesthesia on anesthetic effect and post-anesthesia recovery in patients undergoing supratentorial tumor surgery.Methods:A total of 135 patients with supratentorial tumor resection undergoing elective general anesthesia from April 2018 to October 2019 in Shanxi provincial people’s Hospital were selected as object of study,with both sexes,aged 18-65 year and American Society of Anesthesiologists physical statusⅡ.135 patients were randomly divided into control group,the team 1（Dexmedetomidine group 1）and the team 2（Dexmedetomidine group 2）,with 45 cases in each group.Control group was treated with total intravenous anesthesia and pumped with equal volume normal saline.Before the induction of conventional anesthesia,the the team 1 and the team 2 were injected with dexmedetomidine at 0.5μg/kg loading dose intravenously at 15 minutes before anesthesia induction,followed by continuous pumping at a speed of 0.3μg/kg/h or 0.5μg/kg/h until40 minutes before the end of surgery.To observe:1)The general information;2)The average arterial pressure and heart rate（entry（T₀）,15 minutes after dexmedetomidine administration（T₁）,30 minutes after dexmedetomidine administration（T₂）,1 minute after intubation（T₃）,during skin cutting（T₄）,after removal of the tumor（T₅）,at the end of the operation（T₆）and during tube extubation（T₇））;3)BIS（T₀-T₇）;4)Respiratory function:airway pressure,respiratory rate,tidal volume,end-tidal carbon dioxide partial pressure,oxygen saturation(T_0-1、T₃、T₅、T₇、T₈（when no oxygen was taken at 30 minutes after extubation）);5)S100βprotein（T₀,T₈）;6)Intraoperative narcotic drugs dose;7)Recovery from anesthesia:emergence time,extubation time,stay time in postanesthesia care unit;8)incidence of adverse reactions during operative and anesthetic recovery period.Results:1)There was no significant difference in preoperative and intraoperative data among the three groups（P>0.05）.2)Compared with control group,average arterial pressure and heart rate of patients in team 1 and team 2 were more stable during perioperative,the difference was statistically significant（P<0.05）.3)Compared with control group,the BIS decreased in the team 1 and team 2 at T₁,the difference was statistically significant（P<0.05）;the change of BIS was not obvious in the three groups during anesthesia（P>0.05）.4)Compared with control group,the airway pressure in the team 1and team 2 were more stable during intubation and extubation,respiratory rate and end-tidal carbon dioxide partial pressure were more normal when extubation,tidal volume were more normal when anaesthetic awaking period,the oxygen saturation in the team 1 were more normal when extubation,the oxygen saturation in the team 2 were more normal when anaesthetic awaking period,the difference was statistically significant（P<0.05）.5)Compared with control group,S100βprotein of team 1 and team2 were reduced at T₈（P<0.05）.6)Compared with control group,the intraoperative dosage of propofol and sufentanil in team 1 and team 2 were significantly decreased,and the team 2 was more significant（P<0.05）.7)There was no significant difference in the awake time,extubation time and stay time in postanesthesia care unit among three groups（P>0.05）.8)The incidence of lower heart rate and lower blood pressure in the team 2was significantly higher than control group（P<0.05）;The incidence of agitation,cough,tachycardia and hypertension in team 1 and team 2 were significantly lower than control group（P<0.05）.Conclusion:1)Dexmedetomidine assisted general anesthesia in supratentorial tumor surgery make the perioperative hemodynamic fluctuation more stable,reduce stress response,improve anesthetic effect,maintenance dose is better at 0.3μg/kg/h.2)Dexmedetomidine can reduce the expression of S100βprotein in the early postoperative period,reduce anesthetic side effects,have a protective effect on the brain.