Influence of dexmedetomidine on intraoperative sufentanil dosage and postoperative pain in elderly patients with cirrhotic portal hypertension undergoing TIPS
Objective To explore the influence of dexmedetomidine(Dex)on intraoperative sufentanil dosage and postoperative pain in elderly patients with cirrhotic portal hypertension undergoing transjugular intrahepatic portosys-temic shunt(TIPS).Methods Sixty-eight elderly patients with cirrhotic portal hypertension in Lishui Central Hospital from October 2021 to September 2023 were enrolled.According to the random number table method,they were divided into Dex group(34 cases)and common group(34 cases).All patients were given intravenous general anesthesia,and the Dex group was pumped with Dex before induction of general anesthesia until 30 min before the end of surgery.The changes of peri-anesthesia indicators and hemodynamic indicators,pain status(VAS),stress indicators[cortisol(Cor),endothelin(ET)],cognitive ability(MMSE),incidence rates of cognitive impairment and delirium and adverse reac-tions of anesthetic drugs were compared.Results The extubation time,response time and dosages of propofol and sufen-tanil in Dex group were significantly shorter or less than those in common group(P＜0.05).There were significant differences in heart rate(HR)and mean arterial pressure(MAP)form the aspects of between-group,time-point and in-teraction(P＜0.05).HR and MAP at T,,T2,T3 and T4 in Dex group were significantly lower than those in common group(P＜0.05).There was no obvious difference in blood oxygen saturation(SpO2)between groups(P＞0.05).There was a statistical difference in VAS form the aspects of between-group,time-point and interaction(P＜0.05),and there was a significant difference at different time points within the groups(P＜0.05).The VAS score in Dex group was significantly lower compared to common group at 3 and 6 h after surgery(P＜0.05).At 6 h after surgery,the levels of Cor and ET in both groups were significantly increased(P＜0.05),but the levels in Dex group were significantly lower than those in common group(P＜0.05).Atl d and 3 d after surgery,the MMSE score in the two groups was decreased first and then increased(P＜0.05),and the MMSE score in Dex group at 3 d after surgery was significantly higher com-pared to common group(P＜0.05).The incidence rates of cognitive impairment and delirium in Dex group were signifi-cantly lower than those in common group(P＜0.05).The incidence of adverse reactions of anesthetic drugs revealed a significant difference between groups(P＜0.05).Conclusion Continuous pump infusion of Dex before induction of general anesthesia is beneficial in improving the anesthesia quality in elderly patients with cirrhotic portal hypertension undergoing TIPS.
维普
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