The Effect Of Dexmedetomidine On Perioperative Neurocogntive Disorders After General Anesthesia In Patients With Shoulder Arthroscopic Surgery In Beach Chair Position

Objective: To observe the effect of general anesthesia with dexmedetomidine in patients undergoing shoulder arthroscopic surgery in beach chair position,monitor the vital signs of patients,and record all kinds of data in the whole process of surgery in detail,to explore the role of dexmedetomidine in preventing shoulder arthroscopic surgery in beach chair position Objective to investigate the application value of perioperative neurocogntive disorders in patients undergoing arthroscopic surgery after general anesthesia.Methods: the time of this study was selected from December 2019 to December 2020,and 40 patients were selected.There were all patients undergoing elective shoulder arthroscopic surgery under general anesthesia in the Sixth Affiliated Hospital of Xinjiang Medical University.All patients were randomly divided into two groups: Group D with dexmedetomidine and group N with normal saline.Group D was given dexmedetomidine with concentration of 4ug/ml intravenously within 10 minutes before anesthesia induction.In order to achieve rapid sedation,the loading dose was 0.5 ug/kg.Group N was given normal saline(0.9%)based on Group D.Two groups of patients were given sufentanil,propofol,rocuronium anesthesia induction,two groups were given intravenous injection of propofol and remifentanil hydrochloride for dual channel target controlled infusion,the bispectral index value basically maintained between 45 and 60,recorded the drugs used in the operation and vital signs of patients at each stage,recorded the whole operation time and general anesthesia 1 min before induction(T0),after endotracheal intubation(T1),10 min after beach chair(T2),during skin incision(T3)Control the blood pressure of the patients to the required level of arthroscopic surgery(T4),the average blood pressure and heart rate at the end of the whole operation(T5),the time of extubation(T6),and 1 hour after extubation(T7)and the dosage of drugs,and pay attention to whether there are secondary reactions during the whole operation.After the operation,the patients returned to the ward for 2 hours with visual analogue scale,and the mental examination scale was used to assess the cognitive function of each cognitive range.Analyze the results of the two groups and compare whether there are differences.Results: the heart rate,mean arterial pressure and HR value at T0-T7 in group D were lower than those in group n,and the mean arterial pressure in group D was lower than that in group n,with significant difference(P < 0.05);there was no cognitive problem in the comparison of MMSE scores before operation between the two groups,and the visual simulation score in group D was significantly lower than that in group n,and the difference was statistically significant(P< 0.05)The probability of postoperative cognitive dysfunction in group D was significantly less than that in group n,and the statistical value was P< 0.05;the comparison of postoperative hypotension and bradycardia in group D was more than that in group n,and the comparison of postoperative nausea and vomiting,restlessness in recovery period and shivering in group D was less than that in group n,P <0.05;the dosage of propofol and remifentanil in group D was significantly reduced compared with that in group n,and the difference was statistically significant 05).Conclusion: Dexmedetomidine can decrease PND in patients undergoing shoulder arthroscopic surgery in beach chair position.