Effect Of Different Doses Of Dexmedetomidine Combined With Desflurane Anesthesia On The Quality Of Postoperative Recovery In Elderly Patients

Objective:To investigate the optimal dose of dexmedetomidine for elderly patients combined dexmedetomidine with desflurane anesthesia in order to achieve a satisfactory recovery quality.Materials and Methods:ASA grade Ⅱ-Ⅲ elderly patients aged 65-80years were randomly divided into control group,low dose group（dexmedetomidine 0.3ug/kg/h）,middle dose group（0.5ug/kg/h）and high dose group（0.7ug/kg/h）.ECG,HR,BP,S_PO₂,T were recorded,radial artery cannula were placed before anesthesia,blood gas analysis was performed intermittently during operation,volume of urine and fluid replacement,medication were summarized after operation.Heart rate and meanarterialpressurewererecordedeveryhalfhourafter anesthesia.Postoperatively,the time of eye-opening,extubation,airway protective reflex recovery,orientation recovery,Steward score reaching 6points,cough score and sedation score were recorded.Results:The control group recovered the fastest,with the shortest average time of opening eyes,extubation,airway protective reflex recovery,orientation recovery and steward score reaching 6 points,the difference was statistically significant.But the cough score and sedation score were higher.The time of eye-opening,extubation,airway protective reflex recovery,orientation recovery,Steward score reaching 6 points in low dose group were significantly longer than those in control group（average time was prolonged by 11 minutes,15 minutes,15 minutes,14 minutes and 12minutes respectively）,and the difference was statistically significant.However,the sedation score and cough score did not decrease significantly.The time of eye-opening,extubation,airway protective reflex recovery,orientation recovery,Steward score reaching 6 points in the middle dose group were longer than those in the control group（the average time was prolonged by 12 minutes,13 minutes,13 minutes and 10 minutes respectively）,and the difference was significant.But compared to the low dose group,there was no significant difference.The cough score and sedation score were significantly lower than those of the control group（P<0.05）.The time of eye-opening,extubation,airway protective reflex recovery,orientation recovery,Steward score reaching 6 points in high-dose group were longer than those in control group,low-dose group and middle-dose group,which means the recovery time of patients was delayed.There was no significant difference in eye-opening time,extubation time and recovery time of airway protective reflex among the high-dose group,the middle-dose goup and the low-dose group.There was significant difference in orientation recovery time and the time Steward score reaching 6 points compared to the middle-dose group and the low-dose group.The sedation score and cough score of patients in high-dose group were similar to those in the middle dose group,there was no significant difference.Conclusion:Continuous intravenous infusion of dexmedetomidine at a rate of0.3-0.5ug/kg/h at the beginning of the operation can be safely applied during the operation,maintaining the stability of intraoperative hemodynamics,which lead to satisfactory sedative effect after operation,and at the same time can quickly wake up and improve the quality of emergence.