Clinical Studay On The Effection Of Preoperative Apply Of Dexmedetomidine On The Perioperative In Patients

Objective: To investigate the effect and significance of preoperative intramus-cular injection of dexmedetomidine on the perioperative in patients with general ane-sthesiaMethods:72patients, ASA physical statusⅠ～Ⅱ, including39male cases,female33cases, had been chosen undergoing selective abdominal operations, wererandomly divided into three groups: muscular injection of dexmedetomidine group(Dim group), dexmedetomidine2ug/kg was given i.m.30min before induction ofanaesthesia; intravenous injection of dexmedetomidine group(Div group), dexmedet-omidine1ug/kg was given i.v.30min before induction of anaesthesia; muscularinjection of saline group(Cim group), saline1ml was given i.m.30min before induc-tion of anaesthesia; each group of24cases.After the anesthetic induction and trachealintubation,the patients were ventilated by IPPV in pure oxygen. Anesthesia wasmaintained by propofol, sevofluence, fentanyl and vecuronium.30minutes before thesurgery finished，stopped vecuronium. When the surgery finished, stopped all theanesthetic drugs. Patients were observed in PACU and pulled out the endotrachealtube. Experimental observe the following parameters：Systolic blood pressure (SBP),diastolie blood pressure (DBP), heart rate (HR), and SPO2values were recorded atthe time of premeditation(T0), dexmedetomidine or saline injection(T1),5(T2),10(T3),20(T4),30minutes(T5) after the dexmedetomidine or saline injection, duringtracheal tubation(T6)and1(T7),3(T8),5minutes (T9)after the tracheal tubation,5minutes before tracheal extubation(T10), during tracheal extubation(T11)and5(T12),10(T13),20(T14),30minutes(T15)after the tracheal extubation. Record the RamSayscore and the restless situation assessment after the tracheal extubation. Recordadverse reaction conditions on the perioperative in patients. Evaluation theircognitive functions on a day before operation and the first day, second day, third dayafter operation.Result：(1)hemodynamic：The SBP，DBP，HR values at the time of T2，T3，T4，T5in both Div group and Dim group was significantly lower than those in Cim group(P<0.05). The SBP，DBP，HR values at the time of T3，T4in Dim group wassignificantly better than those in Div group (P<0.05)；The SBP，DBP，HR values atthe time of T7，T8，T9in Cim group was significantly higher than those in both Divgroup and Dim group(P<0.05). The SBP，DBP，HR values at the time of T8，T9inDim group was significantly lower than those in Div group (P<0.05)；The SBP，DBP，HR values at the time of T11，T12in Cim group was also significantly higher thanthose in both Div group and Dim group(P<0.05).(2)The RamSay score in both Divgroup and Dim group was significantly better than those in Cim group(P<0.05)；Theincidence of restless in both Div group and Dim group was significantly lower thanthose in Cim group(P<0.05).(3)The incidence of adverse reaction conditions in Dimgroup was significantly lower than those in both Div group and Cim group(P<0.05).(4)The number of patients with cognitie decline in both Div group and Dim groupwas less than those in Cim group on the first day, second day after operation，butthere was no statistically significant difference between the three groups(P＞0.05).Conclusion: intramuscular injection of dexmedetomidine before operation inpatients with general anesthesia can provide fully sedation，Keep hemodynamicstability in the perioperative，reduce the incidence of postoperative restless andadverse reaction in the perioperative，aviod the incidence of transient hypertensionand delayed recovery，at the same time，probably have a prevention effect on earlierpostoperative cognitive decline.