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Objective:To investigate the effects of dexmedetomidine on stress response and postoperative recovery in children undergoing laparoscopic surgery.Methods:A total of 200 pediatric patients undergoing laparoscopic surgery who received treatment in Jinhua Maternal and Child Health Hospital from May 2021 to December 2022 were included in this prospective randomized controlled study. These patients were randomly divided into Group A and Group B. Group A ( n = 100) received an intravenous infusion of physiological saline before anesthesia induction, while Group B ( n = 100) received an intravenous infusion of 0.5 μg/kg dexmedetomidine, and the other anesthesia methods were the same as the Group A. Vital signs (mean arterial pressure, heart rate), stress reactions (norepinephrine, cortisol, blood glucose), postoperative recovery status (eye-opening time, time to orientation, extubation time), the occurrence of restlessness (restlessness score, duration of restlessness), and adverse reactions (nausea, vomiting, tachycardia, laryngeal spasm, respiratory depression) were compared between different time points [before infusion (T0), 10 minutes after infusion (T1), postoperative wakefulness (T2), and 5 minutes after extubation (T3)]. Results:At T1, T2, T3, the mean arterial pressure and heart rate in Group B [(81.53 ± 7.45) mmHg (1 mmHg = 0.133 kPa), (78.32 ± 8.23) mmHg, (85.73 ± 7.28) mmHg, (109.43 ± 7.78) beats/minute, (106.22 ± 7.25) beats/minute, and (112.34 ± 6.74) beats/minute] were significantly higher than those in Group A [(76.39 ± 7.21) mmHg, (73.54 ± 7.41) mmHg, (80.34 ± 6.81) mmHg, (102.58 ± 7.34) beats/minute, (99.14 ± 6.90) beats/minute, (107.76 ± 6.38) beats/minute, t = 4.95, 4.31, 5.40, 6.40, 7.07, 4.93, all P < 0.001]. At 1 day after surgery, the levels of norepinephrine, cortisol, and blood glucose in Group B [(352.73 ± 60.32) ng/L, (310.85 ± 67.61) nmol/L, (4.89 ± 0.97) mmol/L ] were significantly lower than those in Group A [(427.82 ± 72.95) ng/L, (375.33 ± 74.97) nmol/L, (5.53 ± 1.10) mmol/L, t = 7.93, 6.38, 4.36, P < 0.001]. The time to eye-opening, time to orientation, and time to extubation in Group B were (10.06 ± 1.93) minutes, (10.54 ± 2.10) minutes, and (11.92 ± 2.06) minutes, respectively, which were significantly shorter than (11.88 ± 2.14) minutes, (12.43 ± 2.65) minutes, and (14.46 ± 2.43) minutes ( t = 6.31, 5.59, 7.97, all P < 0.001). The pediatric anesthesia emergence delirium score in Group B was (8.19 ± 2.10) points, which was significantly lower than (11.56 ± 2.62) points in Group A ( t = 10.03, P < 0.001). The duration of restlessness in Group A was (7.41 ± 1.27) minutes, which was significantly shorter than (9.33 ± 1.65) minutes in Group B ( t = 9.22, P < 0.001). There was no significant difference in the incidence of adverse reactions between Group A and Group B [8.00% (8/100) vs. 6.00% (6/100), χ2 = 0.30, P > 0.05]. Conclusion:Dexmedetomidine has a good application effect in pediatric laparoscopic surgery. It can stabilize the vital signs of children, reduce stress reactions, facilitate postoperative recovery, and reduce restlessness and adverse reactions.
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Objective To investigate the effects of dexmedetomidine continuous intravenous infusion on the hemodynamic response of ephedrine and the recovery process of patients undergoing neck surgery under general anesthesia.Methods Select elective fitting line surgery under general anesthesia of 100 patients with cervical disease from January 2015 to December 2015 in the First People's Hospital of Yongkang,randomly divided into low dose group and high dose group, 50 cases in each group, before induction of anesthesia, patients received continuous intravenous pumping of dexmedetomidine 0.4μg/kg in low dose group or 0.8μg/kg in high dose group,after ten mins 0.4μg/kg prior to anesthesia induction,until the end of operation withdrawal;5 min after laryngeal mask insertion, ephedrine 0.1 mg/kg were intravenous administered in two groups.Observe the following indicators:the after entering the operation room ( T0 ) , anesthesia before induction ( T1 ) , after induction ( T2 ) , administration of ephedrine ( T3 ) , the maximum value time(TBP,THR) of heart rate and blood pressure in 10 minutes.Increased of HR,SBP,DBP,recovery related indicators.Results HR, SBP and DBP levels compared no significant difference of T0 with two groups,T1, T2 and T3,HR,SBP, DBP were lower than T0 with two groups(P<0.05),high dose group were lower than low dose group of HR, SBP, DBP(P <0.05);TBP and THR no significant difference of two groups,high dose group were higher than low dose group of Increased of HR,SBP,DBP(P<0.05);high dose group were lower than low dose group of after extubation cough score and sedation agitation score(P<0.05).Spontaneous breathing recovery time and extubation time, called the open time, orientation recovery time,the difference between the two groups was not statistically significant.Conclusion 0.8μg/kg dexmedetomidine continuous intravenous injection of ephedrine in patients with neck pressor effect stronger than the 0.4μg/kg,0.8μg/kg compared with 0.4μg/kg can reduce the recovery period of cough and restlessness,different doses had no effect on recovery.