Comparison of intravenous injection of dexmedetomidine and lidocaine on perioperative heart rate and anesthesia recovery quality in patient undergoing laparoscopic hernia repair

doi:10.3877/cma.j.issn.1674-392X.2024.05.017

Abstract

Abstract:

Objective

To compare the effect of intravenous injection of dexmedetomidine (Dex)and lidocaine (Lido) on perioperative heart rate (HR) and anesthesia recovery quality in patient undergoing laparoscopic hernia repair.

Methods

Eighty patients undergoing laparoscopic hernia repair from January 2021 to August 2023 were selected and randomly divided into Dex group (intravenous injection of Dex)and Lido group (intravenous injection of Lido) according to random number table method. The perioperative HR, mean arterial pressure (MAP), intraoperative mean sevoflurane inhalation concentration,extubation time, recovery time, incidence rate of agitation, duration of agitation, number of drug remedy,and analgesia score were compared between the two groups. The pain stress biochemical indicators before and immediately after surgery were compared between the two groups, and the occurrence of adverse reactions were recorded.

Results

There were no statistically significant differences in perioperative HR and MAP from the aspects of between groups, time points and interaction (P＞0.05). Compared with the Dex group, the Lido group had significantly lower intraoperative sevoflurane concentration, shorter extubation time and recovery time (P＜0.05). There was no significant difference in the incidence rate of agitation, duration of agitation, number of drug remedy between the two groups (P＞0.05). There was no significant significance in analgesia score between the two groups at 3 hours, 12 hours and 24 hours after surgery (P＞0.05). Compared with before surgery, the serum superoxide dismutase (SOD) in both groups was decreased (P＜0.05) while malondialdehyde (MDA) was increased (P＜0.05), but the difference was not significant in SOD and MDA between the two groups (P＞0.05). There was no statistically significant difference in adverse reactions between the two groups (P＞0.05).

Conclusion

Intravenous injection of Dex and Lido for patients undergoing laparoscopic hernia repair have good anesthesia effect and stable perioperative hemodynamics. However, Lido has shorter extubation time, and faster recovery, and is more conducive to postoperative recovery.

Key words: Dexmedetomidine, Lidocaine, Laparoscopes, Herniorrhaphy, Recovery quality

Feng Zhang, Mengqi Sun, Xiuchun Fang. Comparison of intravenous injection of dexmedetomidine and lidocaine on perioperative heart rate and anesthesia recovery quality in patient undergoing laparoscopic hernia repair[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2024, 18(05): 562-565.

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Figures/Tables 6

组别	例数	性别[例(%)]		年龄(岁, $\overset{ˉ}{x}$ ±s)	美国麻醉医师协会分级[例(%)]		体重指数(kg/m², $\overset{ˉ}{x}$ ±s)
组别	例数	男性	女性	年龄(岁, $\overset{ˉ}{x}$ ±s)	Ⅰ	Ⅱ	体重指数(kg/m², $\overset{ˉ}{x}$ ±s)
Dex组	40	39(97.50)	1(2.50)	66.12±3.46	26(65.00)	14(35.00)	24.31±1.58
Lido组	40	38(95.00)	2(5.00)	63.24±2.37	23(57.50)	17(42.50)	24.27±1.67
t/χ²值		1.920		0.181	0.474		0.110
P值		0.166		0.857	0.491		0.913

组别	例数	性别[例(%)]		年龄(岁, $\overset{ˉ}{x}$ ±s)	美国麻醉医师协会分级[例(%)]		体重指数(kg/m², $\overset{ˉ}{x}$ ±s)
组别	例数	男性	女性	年龄(岁, $\overset{ˉ}{x}$ ±s)	Ⅰ	Ⅱ	体重指数(kg/m², $\overset{ˉ}{x}$ ±s)
Dex组	40	39(97.50)	1(2.50)	66.12±3.46	26(65.00)	14(35.00)	24.31±1.58
Lido组	40	38(95.00)	2(5.00)	63.24±2.37	23(57.50)	17(42.50)	24.27±1.67
t/χ²值		1.920		0.181	0.474		0.110
P值		0.166		0.857	0.491		0.913

组别	例数	心率(次/min)				平均动脉压(mmHg)
组别	例数	入室时	插管时	切皮时	拔管后	入室时	插管时	切皮时	拔管后
Dex组	40	77.36±10.34	69.69±11.22	68.98±8.36	74.21±7.38	101.28±10.58	109.67±10.42	89.68±8.36	97.64±8.47
Lido组	40	78.68±10.46	68.87±10.36	67.46±8.29	75.68±10.60	103.28±12.45	108.46±11.12	90.47±9.20	98.12±9.57
F值		F _组间=0.196，F_时间=0.434，F_交互=0.027				F _组间=0.046，F_时间=0.056，F_交互=0.222
P值		P _组间=0.128，P_时间=0.189，P_交互=0.964				P _组间=0.472，P_时间=0.554，P_交互=0.627

组别	例数	平均七氟烷吸入浓度(%)	拔管时间(min)	苏醒时间(min)
Dex组	40	2.47±0.22	14.52±3.26	10.12±2.74
Lido组	40	2.28±0.20	12.58±2.78	8.69±1.59
t值		4.042	2.864	2.855
P值		＜0.001	0.005	0.006

组别	例数	躁动发生率[例(%)]	躁动持续时间(min, $\overset{ˉ}{x}$ ±s)	药物补救次数[例(%)]
Dex组	40	2(5.00)	7.42±1.28	3(7.50)
Lido组	40	1(0.25)	6.99±1.47	2(5.00)
t/χ²值		0.157	1.395	0.213
P值		0.692	0.167	0.644

组别	例数	躁动发生率[例(%)]	躁动持续时间(min, $\overset{ˉ}{x}$ ±s)	药物补救次数[例(%)]
Dex组	40	2(5.00)	7.42±1.28	3(7.50)
Lido组	40	1(0.25)	6.99±1.47	2(5.00)
t/χ²值		0.157	1.395	0.213
P值		0.692	0.167	0.644

组别	例数	术后3h	术后12h	术后24h
Dex组	40	4.16±0.86	3.28±0.87^a	2.59±0.89^ab
Lido组	40	4.02±0.76	3.06±0.94^a	2.34±1.08^ab
t值		0.771	1.086	1.130
P值		0.443	0.281	0.262

组别	例数	血清超氧化物歧化酶(U/L)		丙二醛(noml/ml)
组别	例数	术前	术后即刻	术前	术后即刻
Dex组	40	441.58±26.96	392.68±24.68^a	4.64±0.57	5.32±0.82^a
Lido组	40	446.49±24.87	389.57±23.46^a	4.58±0.69	5.24±0.79^a
t值		0.867	0.578	0.424	0.444
P值		0.400	0.565	0.673	0.658

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