Effect Of Dexmedetomidine Hydrochloride Combined With Limb Remote Ischemic Preconditioning On Quality Of Recovery From Anesthesia In Patients Undergoing Thoracoscopic Lobectomy

Objective: To discuss the effect of limb remote ischemic preconditioning combined with dexmedetomidine hydrochloride on quality of recovery from anesthesia in patients undergoing thoracoscopic pulmonary lobectomy. Methods: A total of 40 patients underwent selective thoracoscopic lobectomy were divided into control group (group C) and limb remote ischemic preconditioning combined with dexmedetomidine treatment group (group ORD) by random number table method. in group ORD, 15 min after the completion of tracheal intubation, the blood flow of right upper limb was blocked for 5 min, and the perfusion was restored for 5 min (repeated 3 times); then ischemic preconditioning was performed, at the same time, intravenous infusion of 0.5 mu g/kg dexmedetomidine was performed for 15 min and continued at a speed of 0.5 mu g/(kg. h)until the end of the surgery. There was no limb remote ischemic preconditioning in group C, while intravenous infusion was performed with equal volume of normal saline. In the two groups, radial artery blood-gas analysis was performed before anesthesia induction (T1), after anesthesia (T2) and at the moment of palinesthesia (T3); P (A-a) DO2 and oxygenation index (OI) were calculated. The recovery quality and complications in the two groups were observed and recorded; the indexes included the recovery time of spontaneous respiration, time of eye opening, extubation time as well as the occurrence of postoperative bucking, restlessness, pain, nausea, vomiting, shivering and other complications during the recovery. Results: Compared with group C, the OI were increased and the respiratory indexes were decreased in group ORD at T2 and T3 (all P<0.05). There was no statistical difference in OI and respiratory index between the two groups at T1 (both P>0.05). The recovery time of spontaneous respiration, time of eye opening and extubation time between the two groups were similar (all P>0.05). The incidences of postoperative bucking, restlessness and pain 30 min after T3 in group ORD were lower than those in group C (all P<0.05). The incidences of shivering, nausea and vomiting in the two groups were similar (both P>0.05). Conclusion: The quality of recovery from anesthesia and the safety during recovery period can be improved in patients undergoing thoracoscopic pulmonary lobectomy when treated with dexmedetomidine hydrochloride combined with limb remote ischemic preconditioning.