Clinical Effects of Dexmedetomidine and Propofol for Anesthesia in Endonasal Surgery
Objective:To compare the effects of dexmedetomidine and propofol for anesthesia in endonasal surgery on intraoperative bleeding and quality of recovery from anesthesia.Methods:60 patients who underwent elective nasal endoscopic surgery of the hospital from Jun.to Dec.2021 were selected for the study and were randomly equated into dexmedetomidine group(Group D)and propofol group(Group P).After induction of anesthesia,group D was pumped with dexmedetomidine 0.2～0.5 μg/(kg-h)for anesthesia maintenance,whereas group P was pumped with propofol target blood levels of 3.0～6.0 μg/mL.The anesthetic conditions,surgical conditions,mean arterial pressure(MAP)and heart rate(HR)at the completion of surgery(T1),eye opening(T2),extubation(T3)and 1 min(T4),5 min(T5),10 min(T6)after extubation,agitation and pain at T4,T5,T6 and 20 min(T7),30 min(T8),40 min(T9)after extubation,application of propofol or fentanyl after extubation,and nausea and vomiting were compared between the two groups.Results:Patients in group D had a median choking score of 1,a mean bleeding volume of(200.9±30.1)mL,and a median field quality score of 4.Patients in group P had a median choking score of 2,a mean bleeding volume of(196.8±29.5)mL,and a median field quality score of 5.The HRs of T1,T2,T3,T4,T5,and T6 of patients in group D were significantly lower than those of group P,and the difference was statistically significant(t=2.305,2.386,2.451,2.785,2.575,2.466;P＜0.05).The rates of T4,T5,T6 and T7 agitation and pain in group D were significantly lower than those in group P,and the difference was statistically significant(χ2=0.5192,4.812,5.455,4.043,5.455,6.667,5.455,5.963;P＜0.05).The application of propofol or fentanyl after extubation in group D was significantly less than that in group P,and the difference was statistically significant(P＜0.05).Conclusion:Dexmedetomidine combined with remifentanil and sevoflurane for anesthesia for nasal endoscopic surgery significantly reduces the choking response during extubation,decreases the incidence of postoperative agitation,and reduces the occurrence of pain when compared with propofol.
万方数据
维普
