| ObjectiveIn order to explore the clinical effect of dexmedetomidine in inhibiting restlessness and hemodynamic fluctuation in patients undergoing thyroid surgery during recovery from general anesthesia,and to evaluate the safety and feasibility of dexmedetomidine in thyroid surgery.MethodsSelected 90 patients who underwent thyroid surgery under general anesthesia from November 2020 to February 2022 in the Affiliated Central Hospital of Shenyang Medical College,and were divided into three groups according to the random number table method.Dexmedetomidine 0.5μg·kg-1group D1（n=30）,dexmedetomidine0.7μg·kg-1group D2（n=30）and normal saline control group N（n=30）.Fasting water and taking no drugs for 8 hours before operation.The drugs used for anesthesia induction were midazolam,sufentanil,cisatracurium,propofol,and propofol.Anesthesia was maintained by continuous intravenous infusion of phenol and remifentanil and sevoflurane inhalation,and cisatracurium was used as needed.After complete thyroidectomy,group D1 and group D2 were injected with dexmedetomidine at a constant rate of 0.5μg·kg-1and 0.7μg·kg-1for 10 minutes,respectively.Group N was injected with 50 ml of normal saline at a constant rate of intravenous injection for10 minutes.minute.During the muscular suture of thyroid surgery,the concentration of sevoflurane was adjusted to 0.5%-0.7%.All three groups of patients were given 5μg sufentanil injection.Sevoflurane was turned off during subcutaneous suture,and the pump injection of propofol and remifentanil was stopped during skin suture The sevoflurane was turned off when the subcutaneous suture was performed,and the propofol and remifentanil were stopped when the skin was sutured.pump.Observe and record the mean arterial pressure,heart rate,blood oxygen saturation immediately after the operation（T1）,immediately after extubation（T2）,5 minutes after extubation（T3）,and 10 minutes after extubation（T4）.of sedation-agitation scores,extubation time,adverse events,and pain scores in the post-anesthesia monitoring treatment unit（PACU）.ResultsA total of 90 patients were included in the statistical analysis.There were no significant differences in age,gender,body mass index（BMI）and operation time among the three groups（P>0.05）.During extubation,the SAS scores of groups D1 and D2 were significantly lower than those of group N;the proportion of people with SAS score≥5 was 4 cases（13.3%）in group D1,3 cases（10%）in group D2,and 3 cases（10%）in group N.There were 12 cases（40%）,D1 group and D2 group were significantly lower than N group,the difference was statistically significant（P<0.05）.The mean arterial pressure（MAP）in the three groups was the lowest at T1,significantly increased at T2,and then gradually leveled off.At T1,the MAP of the D2group was significantly lower than that of the N group,and the difference was statistically significant（P<0.05）,the difference between D1 group and D2 group was not statistically significant（P>0.05）.The heart rate（HR）of the three groups was the lowest at T1,increased at T2,and then gradually leveled off.At T1,the HR of D2group was significantly lower than that of N group,and the difference was statistically significant（P<0.05）.At T2,T3 and T4,the heart rate（HR）of D1 and D2 groups was significantly lower than that of N group,and the difference was statistically significant.Significant（P<0.05）,the difference between D1 group and D2 group was not statistically significant（P>0.05）.The difference of SPO2 between D1,D2 and N groups at T1,T2 and T3 was not statistically significant（P>0.05）,but at T4,D2 group was higher than N group,the difference was statistically significant（P<0.05）.The extubation time of group D2 was significantly higher than that of group D1 and group N,and the difference was statistically significant（P<0.05）.There were 0 cases（0%）in D1 group and D2 group,and 14 cases（46.67%）in N group,and the difference was statistically significant（P<0.05）.The difference of adverse reactions among the three groups was not statistically significant（P>0.05）.ConclusionsFor patients undergoing thyroid surgery under general anesthesia,after thyroidectomy,continuous intravenous infusion of two different doses of dexmedetomidine for 10 minutes can inhibit the agitation during the recovery period of general anesthesia,make the hemodynamics more stable during the recovery period,reduce the heart rate and lower the pain score of patients compared with the normal saline control group.In terms of extubation time,dexmedetomidine of 0.5μg·kg-1did not affect the extubation time of patients,0.5μg·kg-1Dexmedetomidine at 0.7μg·kg-1can significantly prolong the extubation time of patients. |
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