Effect Of Dexmedetomine On Pulmonary Compliance And Oxygenation In Elderly Patients Undergoing One-lung Ventilation Anesthesia

Objective:To investigate the effect of dexmedemidine on anesthesia of patients undergoing thoracic surgery in the elderly patients and to observe the effects of dexmetomidine on respiratory mechanics,pulmonary oxygenation and postoperative pulmonary complications in elderly patients.Methods:Forty patients with ASA grade I or II,regardless of gender,age>60 years,BMI 18-25 kg/m~2,were selected from the Department of Thoracic Surgery,Tumor Hospital Affiliated to Guangxi Medical University.The patients were divided into experimental group(dexmedetomidine group A)and control group(saline group B)with 20 cases in each group.The experimental group was transfused with dexmedetomidine at 0.5 ug/(kg·h)to end of the operation,while the control group was transfused with saline at the same rate.Both groups were ventilated by total intravenous anesthesia and PCV-VG mode.BIS was maintained between 40 and 60,PetCO2 was between 35 and 45 mmHg,heart rate and blood pressure were maintained within 20%of the baseline value,and vasoactive drugs were given when necessary.The time of entering the operating room was recorded as T1,tracheal intubation immediately as T2,tracheal intubation 5 min as T3,one-lung ventilation 30 min as T4,one-lung ventilation120 min as T5,two-lung ventilation 15 min as T6,extubation 15 min as T7,and out of the ICU as T8.The oxygenation at the time points T1,T4-T5,and T8 of the patients and the respiratory mechanics at the T3-T6 time point were recorded.Result:One,With the prolongation of single lung ventilation time,the oxygenation index of patients decreased gradually.The comparison between groups A and B,T4-T5 time point,the oxygenation index of group A was higher than that of group B,the difference was statistically significant.(P<0.05);Two,A,B group comparison,T4-T5 time point,group A Ppeak,Pplat were lower than group B,Cdyn was higher than group B,the difference was statistically significant(P<0.05);Three,A,B group comparison,group A hemodynamic changes were more stable than group B,the difference was statistically significant(P<0.05);Four,intraoperative propofol and remifentanil dosage,group A compared with group B,group A was lower,the difference was statistically significant(P<0.05).Conclusion:Intraoperative continuous infusion of DEX at a rate of0.5ug/(kg·h)until the end of surgery can improve the oxygenation and lung dynamic compliance of patients undergoing radical anesthesia for lung cancer.