Effects Of Different Doses Of Dexmedetomidine On Postoperative Analgesia,Sleep And Gastrointestinal Function In Patients With Colorectal Cancer

Background and PurposeGastrointestinal surgery can lead to severe postoperative sleep disorders and impaired gastrointestinal function and affect postoperative recovery.Dexmedetomidine in postoperative analgesia can inhibit the inflammatory response,reduce stress,reduce the amount of opioids,reduce the impact of anesthesia on sleep.In this study,we studied the effects of different doses of dexmedetomidine on postoperative analgesia,sleep quality and gastrointestinal function recovery.MethodsThis study is a prospective randomized controlled clinical trial.A total of 223 convalescent patients with colorectal cancer of different ages who agreed to receive intravenous injection after successful surgery were selected.The experiment was divided into three groups.Experimental Control group DEX 0μg: sufentanil 150μg combined with normal saline 300 ml.Experimental group DEX 200μg: sufentanil150μg+ dexmedetomidine 200μg combined normal saline 300 ml.Experimental group DEX 400μg: sufentanil 150μg+ dexmedetomidine 400μg combined with normal saline300 ml.VAS scale was used to measure the pain degree of the patients 2h,24 h and 48 h after the operation.At 24 h and 48 h,respectively,Ramsay sedation scale was used to determine the sedation degree of patients.Daily sleep quality was assessed using the AIS score scale within seven days after surgery.ResultsA total of 223 patients were included in the randomized group from 1 July 2019 to30 December 2019.Thirteen cases were excluded due to patients’ voluntary withdrawal and altered postoperative analgesia,and 210 cases were eventually included in the analysis.There were 70 cases in each group.There was no difference in age,height,weight,gender,ASA,and type of surgery.In the DEX 200μg and DEX 400μg groups,the AIS scores were lower than those in the DEX 0μg group(P<0.05)for 7days after surgery.The incidence of sleep disorders within 7 days after surgery was significantly lower in the DEX 200μg and DEX 400μg groups than in the DEX 0μg group.The incidence of postoperative sleep disorders greater than 3 days was significantly lower in the DEX 200μg group(4.3% vs.21.4%,P<0.05),and significantly lower in the DEX 400μg group(0 vs.21.4%,P<0.001).There was no significant difference in the static VAS scores,dynamic VAS scores and RSS scores of2 h,24h and 48 h after surgery.After surgery,the PCA effective press number DEX200μg group is lower than the DEX 0μg group(P=0.013),and there is no significant difference between the other groups.There was no significant difference between the sufentanil dosage groups after surgery.There was no significant difference between the time groups of first exhaust,defecation and eating after surgery.There was no significant difference in the incidence of nausea and vomiting after surgery.ConclusionsThe application of DEX 200μg and 400μg to postoperative analgesia significantly improved the sleep quality of patients 7 days after surgery,reduced the incidence of sleep disorders 7 days after surgery,and reduced the incidence of postoperative insomnia.There was no significant effect on exhaust,defecation and feeding 7 days after the operation.