The Effect of Different Doses of Dexmedetomidine in Elderly Surgical Patients
Objective To explore the correlation between lung function and dexmedetomidine dose in elderly patients with laparoscopic cholecystectomy(LC)with obstructive ventilation dysfunction.Methods The randomized numerical table method was employed to categorize 126 elderly patients with LC and obstructive ventilation dysfunction who were admitted to the Second People's Hospital of Henan Province between September 2020 and March 2023.These patients were divided into three groups:Group A(dexmedetomidine dose of 0.2 μg/kg),Group B(dexmedetomidine dose of 0.4 μg/kg),and Group C(dexmedetomidine dose of 0.6 μg/kg).A total of 42 cases were included in each group.The mean airway pressure(Pmean),airway plateau pressure(Pplat),airway peak pressure(Ppeak),driving pressure,blood gas analysis indexes,as well as extubation time and complications were compared among the patients in the three groups at different times:immediately after the establishment of the pneumoperitoneum(T1),before the end of the pneumoperitoneum(T2),and at 10 min after the end of the pneumoperitoneum(T3).Results The Pmean,Pplat,Ppeak,and driving pressure at T1,T2,and T3 in group B were found to be lower than those in groups A and C.These differences were statistically significant(P＜0.05),whereas the differences between groups A and C were not statistically significant(P＞0.05).Additionally,the oxygenation index(OI)was observed to be higher than that in groups A and C.At T1,T2,and T3 in group B,the differences were statistically significant(P＜0.05).The B respiratory index(RI),dead space ventilation rate(VD/VT),and alveolar-arterial oxygen partial pressure difference(A-aDO2)were lower in group B than in groups A and C,and the differences were statistically significant(P＜0.05).The differences between groups A and C were not statistically significant when comparing groups A and C(P＞0.05).The time of extubation in group B was shorter than that in groups A and C,and the differences were statistically significant(P＜0.05).The differences between groups A and C were not statistically significant(P＞0.05).The observed differences were not statistically significant(P＞0.05).Similarly,the incidence of postoperative hypercapnia(PHY)and hypoxemia among the three groups was not statistically significant(P＞0.05).Conclusion The effects of dexmedetomidine maintenance dose of 0.4 μg/kg/h on airway pressure and blood gas analysis indexes in elderly patients with LC with obstructive ventilation dysfunction were found to be lower than those of 0.2 μg/kg/h and 0.6 μg/kg/h.Furthermore,the use of this dose was found to shorten the time to extubation in the postoperative period without increasing the risk of postoperative complications in patients.
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