Effect of intravenous infusion dose of dexmedetomidine during Da Vinci robot-assisted transoral thyroidectomy on remifentanil-induced postoperative hyperalgesia
Objective:To explore the effect of different intravenous infusion doses of dexmedetomidine during Da Vinci robot-assisted transoral thyroidectomy on remifentanil-induced postoperative hyperalgesia.Methods:90 patients who underwent Da Vinci robot-assisted transoral thyroidectomy in the Second Affiliated Hospital of Air Force Medical University from April 2020 to May 2023 were selected and divided into the group A and group B using a random number table,with 45 cases in each group.Patients in the group A were given intravenous infusion of 0.3μg/(kg·h)dexmedetomidine and 0.6μg/(kg·h)to the group B.Hemodynamics,awakening and extubation time,pain degree,and hyperalgesia between the two groups of patients were compared.Results:Inter-and intra-group comparison of heart rate(HR),SpO2 and mean arterial pressure(MAP)at different time points showed significant difference.LSD-t test results showed that HR of the two groups increased at T1 and T2(P<0.05),MAP increased at T1 in group B(P<0.05),and SpO2 in the two groups increased at T1,T2,and T3(P<0.05).However,compared with the group B,the difference in levels of HR,MAP,and SpO2 of group A at T1,T2,and T3 were not statistically significant(P>0.05).Awakening and extubation time in the group A were shorter than those in the group B(P<0.05),and the difference in amount of fentanyl used in the two groups was not statistically significant(P>0.05).Intra-group comparison showed significant difference in the VAS score at different time points,but there was no statistically significant difference in VAS scores between the two groups at 2 h,8 h,12 h and 24 h after surgery(P>0.05).No significant difference in the incidence of pain hypersensitivity was found between the two groups(P>0.05).Conclusion:After remifentanil induced infusion in patients undergoing Da Vinci robot-assisted transoral thyroidectomy,intraoperative intravenous infusion of 0.3 and 0.6 μg/(kg·h)dexmedetomidine dexmedetomidine could stabilize hemodynamics,alleviate pain,and lower pain hypersensitivity,but intravenous infusion of 0.3 μg/(kg·h)dexmedetomidine could shorten patients'recovery and extubation time.