Effect Of Continuous Infusion Of Dexmedetomidine On Postoperative Recovery Of Patients With Esophageal Cancer Under Multimodal Analgesia

Objective:To investigate the effect of different doses of dexmedetomidine on the quality of recovery after esophageal cancer surgery under multi-modal analgesia,and to find the appropriate dose of dexmedetomidine.Methods:120 patients with esophageal cancer from February 2017 to February 2018 in the First Affiliated Hospital of Xiamen University were randomly divided into four groups:A,B,C and D.During the operation,dexmedetomidine was given O,O.lug/kg.h,0.2ug/kg.h,0.4ug/kg.h continuous infusion.Each group had 30 patients.MAP,T,HR,PETCO2,BIS,sedation score,restlessness score,SPO2 value in the state of oxygen inhalation and deoxygenation were observed and recorded at extubation(TO),1 hour(T1),2 hours(T2),4 hours(T3)and 6 hours(T4).The extubation time,eye opening time and speech communication time were recorded.Results:The blood pressure and heart rate of group A were significantly higher than those of group B,group C and group D at TO after operation,with significant difference(p<0.05).At T1,T2,T3 and T4,the heart rate of group D was significantly lower than that of group B,C and D,with significant difference(p<0.05).The restlessness score of group A was higher than that of group B,C and D at T0,while the sedation score was lower than that of group B,C and D,with significant difference(p<0.05).At T1,T2,T3 and T4,the sedation score of group D was higher than that of group A,B and C,with significant difference(p<0.05).At T0 T1,T2,T3 and T4,the BIS value of group D was lower than that of group A,B and C,with significant difference(p<0.05).SPO2 in group D was significantly lower than that in group A,B and C(p<0.05).The opening time and response time of group D were longer than those of group A,B and C,and there was significant difference(p<0.05).CONCLUSION:Continuous intraoperative dexmedetomidine infusion(greater than 0.4ug/kg.h)can lead to prolonged tracheal catheterization,hypoxia(deoxygenation)and delayed recovery in patients with esophageal cancer after multimodal analgesia.After tracheal extubation,the patients with low dose of dexmedetomidine(0.1-0.2ug/kg.h)were less stressed,quiet and comfortable,and their vital signs were stable,which had clinical value.