| Objective:To investigate the effect of intraoperative dexmedetomidine given in different doses on preventing postoperative chills in patients undergone nevus resection.Methods:Patients with hemorrhoids who were admitted to our hospital from January 2016 to August 2016 were required to undergo hemorrhoidectomy in 150 patients,84 males and66 females,aged 19-38 years(average 31.4±2.1 years),ASAI-Level II,BMI 21-28,anesthesia time 30-60 min,random number table method is divided into A,B,C three groups.There was no statistically significant difference in age,gender,ASA rating and BMI index between each group(P>0.05).Three groups of patients did not ate diet for8-10 hours before surgery,and the operating room temperature remained constant(23±1°C).The patient did not use preoperative drugs.After entering the operating room,he opened a relatively thick and smooth venous access.The patient received routine oxygen inhalation,set the oxygen flow to 2 L/min,and connected to a multi-function monitor to monitor the patient's vital signs(ECG,SPO2,HR,Give 6 to 10 m L/kg Lactated Ringer's Injection before subarachnoid block to prevent the risk of hypotension caused by subarachnoid block.When performing anesthesia and puncture operation,the patient's position selection level In the left lateral decubitus,a local infiltration anesthesia was performed at a puncture site using a total of 1% lidocaine less than 5 m L,and the puncture needle enters into the subarachnoid space through the L2-3 space,and the needle is inserted vertically.See clear CSF leakage confirmed to reach the subarachnoid space,then bolus injection of glucose solution diluted with 0.5% ropivacaine injection 3m L,adjust the patient position to maintain the anesthetic plane at T8-10,if the L2-3 gap puncture failure No other gaps were attempted,and the technical failure was recorded.In group A,anesthetic preparation was performed simultaneously with 0.9% physiological saline injection.In group B,anesthesia preparation was given with 0.4?g kg-1dexmedetomidine intravenous injection,group C.Patient hemp Prepare intravenous dexmedetomidine at a dose of 0.6 ?g·kg-1,and the intravenous pumping time will be 10 minutes for all three groups of patients.If the patient has hypotension,slow heart rate,and respiratory depression during perioperative anesthesia,timely symptomatic treatment is required.If hypotension occurs during surgery(blood pressure is less than 90/60 mm Hg or less than the original base value of 30),intravenous ephedrine 6 mg,add 30 mg isinvalid,change to other boost drugs,if the heart rate is less than 50 beats / min Give atropine.Observe the patient's body temperature(T),heart rate(HR),respiratory rate(RR),mean arterial pressure(MAP),oxygen saturation(Sp O2),before and 10 minutes,30 minutes,60 minutes,and 90 minutes after the intravenous pump injection.chills Wrench classification and changes in the alertness/sedation(OAA/S)score.Results:There was no significant difference in T,RR and Sp O2 between the three groups before and after intravenous injection(P>0.05).There was no significant difference in HR and MAP between the three groups before injection(P>0.05).The HR and MAP at each time point in group C were lower than those in group A at 10 min after administration(P<0.05).The sedation rate of patients in group B and group C was higher than that in group A(P<0.05).The sedation rate between group B and group C was not statistically significant(P>0.05).The incidence of chills in the three groups was highest in group A,and the incidence of chills in group B and group C was lower than that in group A(P<0.05).The incidence of chills among group B and group C was not statistically significant(P> 0.05).Conclusion:Preinfusion of dexmedetomidine at 0.4?g·kg-1·0.6?g·kg-1 can reduce the incidence of chills during operation and reduce postoperative anxiety in patients undergoing hemorrhoid surgery.reaction. |
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