Comparative Analysis Of The Effect Of Intravenous Lidocaine And Dexmedetomidine Under General Anesthesia

ObjectiveTo explore the intravenous infusion of lidocaine(induction dose:10min constant speed pump lmg/kg,maintenance dose:2mg/kg/h)and intravenous infusion of dexmedetomidine(induction dose:10min constant speed pump 0.5 μg/kg,maintenance dose:constant speed pumping 0.4 μg/kg/h)in general anesthesia.Methods90 patients aged 30-60 who underwent elective surgery for lower limb tibiofibular fractures under general anesthesia at the Affiliated Central Hospital of Shenyang Medical College from November 2020 to March 2022 were selected and approved by the Ethics Committee with the number SYMC-20230105-012.The anesthesia time for the surgery was controlled within 2-2.5 hours.Using a random sampling method,30 patients were assigned to Group A(control group),30 patients to Group B(lidocaine group),and the remaining 30 patients to Group C(dexmedetomidine group).Record the various vital signs of two groups of patients at different time periods.Record the effective heart rate(HR),blood pressure(BP),entropy index(EI),and cough response during extubation of the patient at different times.Observe the adverse reactions of the patient during and after extubation(including cough,breathlessness,restlessness,laryngeal spasm,bronchospasm,nausea,vomiting)and treat them accordingly.ResultsThere was no significant difference in age,body mass index and ASA grade among the three groups(P>0.05).The heart rate at the end of operation(T5)and at the time of extubation(T6)in group A were significantly higher than those at the time of induction(T1),and the difference was statistically significant(P<0.05);The heart rate(T5)at the end of operation in group B was not significantly different from the heart rate at induction,and the difference was not statistically significant.The heart rate(T6)at extubation was significantly higher than the heart rate(T1)at induction,and the difference was statistically significant(P<0.05);The heart rate(T5)at the end of the operation and the heart rate(T1)at the time of induction were significantly lower in group C(P<0.05).The heart rate(T6)at the time of extubation and the heart rate(T1)at the time of induction had no significant difference.There was no significant difference in blood pressure(T5)at the end of operation compared with that at induction in group A,and the blood pressure at extubation(T6)was significantly higher than that at induction(T1),and the difference was statistically significant(P<0.05);There was no significant difference in blood pressure(T5)at the end of operation compared with that at induction in group B,and the blood pressure at extubation(T6)was significantly higher than that at induction(T1),and the difference was statistically significant(P<0.05);There was no significant difference in blood pressure(T5)at the end of operation and blood pressure(T1)at induction in group C,and there was no significant difference in blood pressure(T6)at extubation and blood pressure(T1)at induction.The change of entropy index in T1-T5 of the three groups was statistically significant(P<0.05):the change was relatively stable in Group B,and the fluctuation in Group A and Group C was relatively large.Compared with Group A,the incidence and degree of choking in Group B and Group C were significantly lower.However,there was no significant difference between Group B and Group C.There was a significant difference in HR between the three groups at T2-T6(P<0.05).The heart rate of patients in Group B and Group C was significantly lower than that of patients in Group A at T2-T6.There was no significant difference in heart rate of group A,B and C at T1(P>0.05).There was a significant difference in BP between the three groups at T2,T3,T5 and T6(P<0.05),and there was a significant difference in systolic blood pressure at T4 in groups A,B and C(P<0.05).At T2,the systolic blood pressure in group B was significantly lower than that in group A and group C,and the diastolic blood pressure in group A was significantly higher than that in group B.At the time of T3,the systolic blood pressure of group C was significantly higher than that of group A and group B,and the diastolic blood pressure of group A,B and C were significantly different.At the time of T5,the systolic blood pressure of group C was significantly higher than that of group A and group B,and the diastolic blood pressure of group A,B and C were significantly different.At T6,the systolic blood pressure of group A was significantly higher than that of group B,group C,and the diastolic blood pressure of group A was significantly higher than that of group B.At T4,the systolic blood pressure of group A was significantly lower than that of group B and group C.There was significant difference in EI between the three groups at T2,T3 and T5(P<0.05).At T2,the three groups of entropy indexes have pairwise differences.At T3,the entropy index of group A was significantly higher than that of group B and group C.At T5,the entropy index of group C was significantly higher than that of group A and group B.ConclusionLidocaine:induction dose:10min constant speed pumping lmg/kg,maintenance dose:constant speed pumping 2mg/kg/hDextrmetomidine:induction dose:10min constant speed pump 0.5μg/kg,maintenance dose:constant speed pumping 0.4μg/kg/h Compare the drugs corresponding to the above two doses:Lidocaine has more stable hemodynamic performance than dexmedetomidine in intubation and extubation.Compared with lidocaine,dexmedetomidine has more stable hemodynamic performance in the maintenance of intravenous and inhalation combined general anesthesia.Lidocaine is better than dexmedetomidine in monitoring the depth of anesthesia.Both lidocaine and dexmedetomidine can inhibit the cough reaction after extubation.