Effect of oxycodone combined with dexmedetomidine on stress response of general anesthesia for intubation in patients undergoing endoscopic thyroid surgery
Objective To compare the effect of hydrocodone combined with dexmedetomidine with that of sufentanil com-bined with dexmedetomidine on patient stress response during general anesthesia for intubation in thyroid endoscopy surgery.Methods A total of 84 patients who underwent thyroid endoscopy surgery in Hangzhou First People's Hospital from February 2022 to February 2024 were selected as the research subjects and divided into the observation group and control group using a random num-ber table method,with 42 in each group.All the patients in both groups were firstly given dexmedetomidine at a dose of 0.5 μg·kg-1.The patients in the control group received sufentanil 0.3 μg·kg-1 via intravenous infusion and those in the observation group received hy-drocodone 0.2 mg·kg-1 via intravenous infusion.The general data,physical indicators(heart rate(HR),mean arterial pressure(MAP)),stress indicators(plasma adrenaline(E)and norepinephrine(NE))concentrations,and adverse reactions at different time points(before anesthesia(T0),during intubation(T1),1 minute after intubation(T2),and 5 minutes after intubation(T3))were compared between the two groups.Results At the T1 time point,the HR and MAP were(53.08±6.24)times·min-1 and(65.13±7.32)times·min-1 in the con-trol group and(77.62±8.27)mm Hg and(78.31±9.35)mm Hg(1 mm Hg≈0.133 kPa)in the observation group.At the T0 time point,the HR of the control group was lower than that of the observation group((74.72±10.51)times·min-1 vs(76.61±9.62)times·min-1)and the MAP was(93.25±8.57)mm Hg and(94.87±10.59)mm Hg,respectively.The HR of the control group was lower than that of the ob-servation group(P＜0.05).At the T2 time point,the HR was(92.48±9.51)times·min-1 and(71.64±7.49)times·min-1 while MAP was(105.67±7.82)mm Hg and(96.18±10.04)mm Hg in the control group and the observation group,demonstrating increase.At the T3 time point,the HR was(87.92±8.16)times·min-1 and(74.27±7.56)times·min-1 while MAP was(101.46±8.97)mm Hg,(97.53±9.42)mm Hg in the control group and observation group,showing increase.Meanwhile,they were significantly higher in the control group than in the observation group(all P＜0.05).At the T0 time point,the concentrations of E and NE in the control group and study group were(24.92±4.51)ng·mL-1,(327.25±60.57)pg·mL-1,(25.31±4.62)ng·mL-1,(329.87±61.59)pg·mL-1.They were(37.08±6.24)ng·mL-1,(427.62±74.27)pg·mL-1,(32.16±7.32)ng·mL-1,(384.31±70.35)pg·mL-1 at the T1 time point,(36.48±7.51)ng·mL-1,(421.67±60.82)pg·mL-1,(31.64±6.49)n·mL-1,(373.18±65.04)pg·mL-1 at the T2 time point and(34.62±6.47)ng·mL-1,(397.46±58.97)pg·mL-1,(29.47±7.12)ng·mL-1,(361.53±51.42)pg·mL-1 at the T3 time point.They were all higher at T1,T2 and T3 time point than those at T0 time point.Meanwhile,they were significantly higher in the control group than in the observation group(all P＜0.05).The inci-dence of adverse reactions including hypertension,tachycardia and SpO2＜90%in the control group was 4.76%(2/42),9.52%(4/42)and 4.76%(2/42)and it was not significantly different from that of 0.00%(0/42),2.38%(1/42)and 0.00%(0/42)in the observation group(all P＞0.05).Conclusion Oxycodone combined with dexmedetomidine is effective in inducing anesthesia before general anesthesia for intubation in pa-tients undergoing endoscopic thyroid surgery.It can stabilize the hemodynamic indexes of patients and reduce the stress response of patients undergoing general anesthesia for intubation.Furthermore,it is safe and worthy of clinical application.
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