Effect Of Dexmedetomidine Nasal Drops Combined With Ropivacaine Surface Anesthesia On Tracheal Intubation And Extubation Reaction

Objective:In this study,dexmedetomidine nasal drops were given to patients undergoing general anesthesia 30 minutes before anesthesia induction,and ropivacaine was used for airway surface anesthesia after anesthesia induction.To observe its influence on hemodynamics,extubation quality and postoperative recovery quality of patients undergoing general anesthesia operation during intubation and extubation.In order to explore the advantages of combined medication,a safer and more comfortable anesthesia medication scheme was provided for patients undergoing general anesthesia.Methods:A total of 120 patients undergoing thyroidectomy in our hospital from January2021 to December 2021 were randomly divided into four groups（n=30）:control group（group C）,dexmedetomidine group（group D）,ropivacaine group（group R）and dexmedetomidine combined with ropivacaine group（group D+R）.According to the grouping,normal saline or dexmedetomidine was dripped into bilateral nasal cavity 30min minutes before anesthesia induction,and normal saline or ropivacaine was used for throat spray after anesthesia induction.Record the SBP,DBP,MAP,HR of patients before anesthesia induction（T₁）,immediately after intubation（T₂）,2 min after intubation（T₃）,immediately after extubation（T₄）and 2 min after extubation（T₅）,Operation time,Extubation time,Extubation quality score,Ramsay sedation score,Remifentanil dosage,and Occurrence of postoperative adverse reactions.Results:1.There was no significant difference in gender,age,BMI,operation time and anesthesia time among the four groups（P>0.05）.2.Compared with T₁,the SBP,DBP,MAP and HR of the four groups of patients decreased at T₂,and the difference was statistically significant（P<0.05）。At T₃,SBP,DBP,MAP and HR in group C,group D and group R increased in different degrees,and the difference was statistically significant（P<0.05）。Compared with group C,the increase of SBP,DBP,MAP and HR in group D and group R at T3 decreased,and the difference was statistically significant（P<0.05）.Compared with group C,group D and group R,the SBP,DBP,MAP and HR in group D+R at T₃were not significantly increased,and the difference was statistically significant（P<0.05）.Compared with time T₄,SBP,DBP,MAP and HR in group C,group D and group R at time T₅increased in different degrees,and the difference was statistically significant（P<0.05）.Compared with group C,SBP,DBP,MAP and HR in group D and group R at T₅increased slightly,and the difference was statistically significant（P<0.05）.Compared with group C,group D and group R,SBP,DBP,MAP and HR in group D+R at T₅were not significantly increased,and the difference was statistically significant（P<0.05）.3.There was no significant difference in extubation time and remifentanil dosage among the four groups（P>0.05）.Compared with group C,the extubation quality scores of group D and group R and group D+R were all lower,and the difference was statistically significant（P<0.05）.Compared with the other three groups,D+R had statistical significance（P<0.05）.Compared with group C and group R,the Ramsay sedation scores of group D and group D+R were higher,with statistical significance（P<0.05）.There was no significant difference in sedation score between group D and group D+R（P>0.05）.4.The incidence of adverse reactions in D+R group was the lowest compared with the other three groups,and the difference was statistically significant（P<0.05）.Compared with group C,the adverse reaction rates of group D and group R decreased,but there was no statistical difference（P>0.05）.Conclusion:0.5ug/kg DEX nasal drip combined with ropivacaine airway surface anesthesia can effectively stabilize the hemodynamics during intubation and extubation,and reduce the incidence of postoperative adverse reactions.2.Intranasal instillation of 0.5 ug/kg DEX can reduce restlessness in the recovery period and improve the comfort and safety of patients during perioperative period.