The effect of dexmedetomidine combined with laryngeal mask general anesthesia on cerebral oxygen supply and demand balance in patients undergoing acute anterior circulation large vessel occlusion thrombectomy
Ma Taoxia
Wu Jimin
Chen Qin
Jin Linfei
Abstract：Objective To analyze the effect of dexmedetomidine combined with laryngeal mask general anesthesia on cerebral oxygen supply and demand balance in patients undergoing acute anterior circulation large vessel occlusion thrombectomy.Methods A total of 95 patients who underwent acute anterior circulation large vessel occlusion thrombectomy in Lishui People's Hospital,Zhejiang Province from December 2022 to December 2024 were included.According to the random number table method,they were divided into an observation group(47 cases)and a control group(48 cases).The control group received general anesthesia with laryngeal mask,while the observation group received intravenous infusion of dexmedetomidine hydrochloride injection at the beginning of the surgery on the basis of general anesthesia with laryngeal mask.The intraoperative clinical indexes of the two groups were compared,such as the mean arterial pressure(MAP),heart rate and pulse oxygen saturation(SpO2)levels of the two groups were recorded before anesthesia induction(T0),after anesthesia induction(T1),15 min during surgery(T2)and after surgery(T3).The blood oxygen saturation(SjvO2),cerebral oxygen uptake rate(CERO2),arterial oxygen content(CaO2)and internal carotid vein oxygen content(CjvO2)of the two groups were compared at T0,T3 and 24 h after surgery(T4).The national institutes of health stroke scale(NIHSS)scores of the two groups before and after surgery were analyzed.Results The time from puncture to vascular recanalization and the number of thrombectomy in the observation group were shorter/less than those in the control group,and the first recanalization rate was higher than that in the control group(all P＜0.05).The MAP and heart rate of T,,T2 and T3 in the two groups decreased first and then increased,but the MAP and heart rate of T1 and T2 in the observation group were higher than those in the control group(all P＜0.05).There were no time,group and interaction effects on SpO2 of patients in the two groups(all P＞0.05).The SjvO2,CaO2 and CjvO2 of T0,T3 and T4 in the two groups decreased first and then increased,and CERO2 increased first and then decreased,but the SjvO2,CaO2,and CjvO2 of T3 in the observation group were higher than those in the control group,and CERO2 was lower than that in the control group(all P＜0.05).There was no significant difference in NIHSS score between the observation group and the control group before operation[(17.2±2.6)vs(17.2±2.8)](t=0.145,P=0.885).The NIHSS scores of the two groups at 48 h after operation were lower than those before operation,and the NIHSS scores of the observation group were lower than those of the control group[(9.6±1.2)vs(12.4±1.5)](t=10.208,P＜0.001).Conclusion The combination of dexmedetomidine and laryngeal mask general anesthesia can improve intraoperative clinical indicators,stabilize hemodynamics,balance cerebral oxygen supply and demand,and reduce neurological damage in patients undergoing acute anterior circulation large vessel occlusion thrombectomy.
Keywords：Acute anterior circulation large vessel occlusion thrombectomyDexmedetomidineLaryngeal mask general anesthesiaCerebral oxygen supply and demand balance
Publication Date：2025-09-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1319-1323 )