Effect of Dexmedetomidine Dose Selection on Hemodynamics,Brain Function Status Index and Cognitive Function in Patients with Cardiovascular Disease Undergoing General Anesthesia

SONG Leijun

doi:10.3969/j.issn.1004-437X.2025.01.019

Abstract：Objective To investigate the anesthetic effect and application value of different doses of dexmedetomidine in cardiovascular surgery under general anesthesia.Methods A total of 286 elderly patients with hypertension who were scheduled for general anesthesia surgery at the Seventh People's Hospital of Zhengzhou from February 2022 to February 2023 were selected and randomly divided into an observation group(143 cases)and a control group(143 cases)using a random number table method.The control group was injected with 0.6 μg·kg-1 dexmedetomidine intravenously,and the observation group was injected with 0.4 μg·kg-1 dexmedetomidine intravenously.Clinical indexes[extubation time,recovery time,orientation recovery time,consciousness recovery time,Ramsay sedation score 2 hours after surgery,visual analog scale(VAS)score]were compared between the two groups.The levels of haemodynamic indexes[heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),and mean arterial pressure(MAP)],and the values of cerebral functional status index were compared between the two groups with the time points of preoperative(T0),3 minutes after intubation(T1),and at the immediate time of surgery(T2).Preoperative(T0),1 day postoperative(t 1)and 3 days postoperative(t2)were used as time nodes to compare the scores of the mini-mental state examination(MMSE)and the incidence rate of adverse reactions in the two groups.Results The observation group had shorter extubation and recovery time,as well as a shorter recovery time for consciousness and orientation,compared to the control group.Additionally,the VAS score and Ramsay score were lower in the observation group compared to the control group(P＜0.05).The fluctuation amplitude of HR,SBP,DBP,and MAP levels in the observation group during the T0-T2 period was smaller than that in the control group(P＜0.05).The brain function state index values of the observation group at T1 and T2 were lower than those of the control group(P＜0.05).At t1,the MMSE score of the observation group was higher than that of the control group(P＜0.05).The total incidence of adverse reactions in the observation group and the control group was compared(17.48％vs 23.08％),and the difference was not statistically significant(P＞0.05).Conclusion The application of 0.4 μg·kg-1 dexmedetomidine in general anesthesia in elderly patients with hypertension can effectively improve the quality of anesthesia,enhance sedation and analgesia,improve circulation and cognitive function,and ensure its safety.