The effect of dexmedetomidine combined with dyclonine hydrochloride mucilage on agitation during the recovery period of laparoscopic cholecystectomy

Objective:To evaluate the safety and efficacy of dexmedetomidine combined with dyclonine hydrochloride mucilage before general anesthesia in preventing agitation during the recovery period of laparoscopic cholecystectomy.Methods:Eighty patients treated with electively laparoscopic cholecystectomy were randomly divided into the normal saline group(group Ⅰ), dyclonine group(group Ⅱ), dexmedetomidine group(group Ⅲ) and dexmedetomidine combined with dyclonine group(group Ⅳ).The premedication didn't be used in all patients.Group Ⅲ and Ⅳ were treated with a loading dose of dexmedetomidine(0.6μg·kg^-1·h^-1) by intravenous infusion before anesthesia induction.After 15 min, the dose of dexmedetomidine revised by 0.2 to 0.3μg·kg^-1·h^-1.The position between the top of the tracheal tube and 15 cm was evenly covered by dyclonine hydrochloride mucilage in group Ⅱ and Ⅳ, group Ⅰ and Ⅱ were injected with saline infusion.The mean arterial pressure(MAP) and heart rate(HR) in all groups were recorded after operation(T₁), tracheal extubation(T₂) and 5 min after extubation(T₃).The time of recovery and extubation, Riker sedation score before extubation and Ramsay sedation score after 5 min of extubation in four groups were observed.Results:Compared with the T₁, the MAP and HR in group Ⅰand group Ⅱ were significantly higher at T₂ and T₃(P<0.01).The MAP and HR in group Ⅲ and group Ⅳ were lower than those in group Ⅰ at T₁ and T₃(P<0.05 to P<0.01).The differences of the recovery and extubation time in four groups were not statistically different(P>0.05).The Ramsay sedation score in group Ⅳ was significantly higher than that in other three groups(P<0.01).The Riker sedation-agitation scores in group Ⅱ, Ⅲ and Ⅳ were significantly lower than those in group Ⅰ(P<0.01).The incidence of agitation in group Ⅲ and Ⅳ were significantly lower than that in group Ⅰ(P<0.05).Conclusions:The treatment of a loading dose of dexmedetomidine(0.6μg·kg^-1·h^-1) and 0.2 to 0.3μg·kg^-1·h^-1 after 15 min before extubation combined with dyclonine hydrochloride mucilage can effectively prevent agitation of laparoscopic cholecystectomy patients during recovery period, reduce cardiovascular reaction during extubation and not prolong the recovery and extubation time.