EFFECTS OF DEXMEDETOMIDINE-ASSISTED GENERAL ANESTHESIA ON PERIOPERATIVE HEMODYNAMICS, ANESTHETIC DOSAGE AND POSTOPERATIVE SEDATION AND ANALGESIA IN PATIENTS UNDERGOING RADICAL GASTRECTOMY

Wenjuan Li^1#*, Mingxiao Song^1#, Zhining Zhang², Jingyu Zhang³

¹Department of Anesthesiology, Second People's Hospital of Hengshui City, Hengshui, Hebei 053000, China - ²Department of General surgery, Second People's Hospital of Hengshui City, Hengshui, Hebei 053000, China - ³Department of Pharmacy,Second People's Hospital of Hengshui City, Hengshui, Hebei 053000, China

Objective: To analyze the effect of dexmedetomidine-assisted general anesthesia on perioperative hemodynamics, anesthetic dosage, and postoperative sedation and analgesia in patients undergoing radical gastrectomy.

Methods: One hundred and twenty patients who underwent radical gastrectomy under general anesthesia at our hospital from January 2018 to December 2019 were included. The patients were randomly divided into an experimental group and a control group by the random number table method, with 60 patients in each group. In the experimental group, dexmedetomidine infusion was used, while the control group was given equal amount of normal saline infusion. Hemodynamics, epinephrine (E) and norepinephrine (NE) levels, anesthetic dosage, and sedative and analgesic effects were compared between the groups of patients before injection (T0), before induction of anesthesia (T1), before intubation (T2), immediately after intubation (T3), 3 min after intubation (T4), immediately after extubation (T5), and 3 min after extubation (T6).

Results: At T1, the bispectral index (BIS) values in the observation group were significantly lower than those at T0 and lower than those in the control group (76.4±4.0 vs 94.2±2.9), with a statistically significant difference (P<0.05); at T1, T3, and T5, the mean arterial pressure (MAP) and heart rate (HR) values in the control group were all significantly higher than the observation group (P<0.05). The dosages of propofol (1421.7±328.7) and remifentanil (5.4±1.4) in the control group were both significantly higher than the observation group (1009.9±209.5, 3.3±1.3), with statistically significant differences (P<0.05). At 1 h and 4 h after surgery, respectively, the visual analogue scale (VAS) scores of patients in the observation group were significantly lower than those in the control group (1.4±0.7 vs 2.7±1.2, 1.7±0.7 vs 2.2±1.9), and the differences were statistically significant (P<0.05). the Ramsay scale scores in the observation group were significantly higher than those in the control group (3.5±1.1 vs 1.9±0.9, 2.7±0.7 vs 2.0±0.8), and the differences were statistically significant (P<0.05). At T3 and T5, the E and NE concentrations in the control group were significantly higher than those at T2 and higher than those in the observation group (P<0.05), while the change in the observation group was not significant (P>0.05).

Conclusions: The use of dexmedetomidine in radical gastrectomy can effectively reduce the hemodynamic fluctuations and stabilize the epinephrine and norepinephrine levels, lower the dosage of anesthetics, relieve postoperative discomfort, and pain, and provide good analgesic and sedative effects for patients.