Effects of Dexmedetomidine Combined with Remifentanil on Stress Response and Early Postoperative Analgesia in Patients Undergoing Radical Thyroidectomy
To investigate the effects of dexmedetomidine combined with remifentanil on stress response and early postoperative analge-sia in patients with thyroid cancer undergoing radical surgery,102 patients with thyroid cancer admitted to the hospital from June 2020 to October 2022 were selected to receive radical thyroidectomy,and were divided into group A and Group B with 51 cases in each group according to random drawing method.In both groups,0.5 μg/kg(within 10 min)dexmedetomidine was pumped during preparation for surgery,and target-controlled infusion of remifentanil was given after surgery.The plasma target-controlled concentra-tion of remifentanil in group A and group B was adjusted to 1.5 ng/mL and 1.0 ng/mL respectively.The changes of heart rate(HR),mean arterial pressure(MAP)and pulse oxygen saturation(SpO2)before anesthesia induction(T0),before intubation(T1),1 min after intubation(T2)and at extubation(T3)were compared between the two groups.The levels of serum cortisol(Cor),norepinephrine(NE),superoxide dismutase(SOD),malondialdehyde(MDA),substance P(SP),dopamine(DA)and prostaglandin E2(PGE2)in the two groups were detected before and after surgery,and visual analogue pain scale(VAS)was used to evaluate the early postoperative analgesia.The adverse reactions of the two groups were compared.HR and MAP of T3 in group B were higher than those in group A,and SpO2 was lower than those in group A(P＜0.05).The levels of serum Cor,NE and MDA in two groups immediately after surgery,12 h and 24 h after surgery were higher than those before surgery,and the levels of serum SOD in two groups immediately after surgery,12 h and 24 h after surgery were lower than those before surgery,and the levels in group A were higher than those in group B(P＜0.05).Serum SP,DA and PGE2 levels in both groups were higher immediately after surgery,12 h and 24 h after surgery than before surgery,and those in group A was lower than those in group B(P＜0.05).The VAS scores of group A immediately after surgery and 12 h,24 h after surgery were lower than those of group B(P＜0.05).There was no diffe-rence in adverse reaction rate between group A(9.80％)and group B(13.73％)(P＞0.05).When preparing for surgery,dexme-detomidine combined with pirifentanil with plasma target control concentration of 1.5 ng/mL can reduce the stress response of patients undergoing radical thyroidectomy,improve the early postoperative analgesia effect,and have high safety.
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