Application of Different Doses of Dexmedetomidine Combined with General Anesthesia in Anesthesia of Patients with Traumatic Tibiofibular Fractures and Its Effect on the Incidence of Adverse Reactions

Abstract

Objective. To explore the application of different doses of dexmedetomidine combined with general anesthesia in patients with traumatic tibiofibular fractures. Methods. A total of 120 patients with traumatic tibiofibular fractures treated in our hospital (January 2018–January 2021) were selected as the research subjects and equally grouped into group A, group B, group C, and group D according to the dosage of dexmedetomidine. Group B, group C, and group D were pumped with 0.3 μg/kg, 0.5 μg/kg, and 0.8 μg/kg load doses of dexmedetomidine before anesthesia induction, with the same doses for maintenance during surgery. Group A was intravenously pumped with the same amount of normal saline and received tracheal intubation after anesthesia induction, with propofol and remifentanil to maintain general anesthesia during surgery. Results. No notable differences in general data were observed among the groups ( $P$  > 0.05). Ramsay sedation scores of all groups showed a downward trend after drug withdrawal. At 10 min, 30 min, and 60 min, the scores of groups C and D were markedly higher than those of groups A and B ( $P$  < 0.05), and the scores were higher in group D than those in group C ( $P$  < 0.05). The HR changes at each period were close between groups A and B ( $P$  > 0.05). The HRs at T1 and T2 in group C were slightly lower than those in group D ( $P$  > 0.05), and the HRs at T1 in groups A and B were remarkably higher than those in groups C and D, and were higher than those at T0 and T2 ( $P$  < 0.05). The SBP levels of all groups began to rise at T0, peaked at T1, and decreased to a lower level at T2 than that at T0. Moreover, the SBP levels of groups C and D at T1 and T2 were notably lower compared with groups A and B ( $P$  < 0.05). With a lower DBP level in group C than the other three groups at T1, the DBP levels were notably lower in groups C and D than those in groups A and B at T2 ( $P$  < 0.05). With no statistical difference in the MAP levels at T0 among the four groups ( $P$  > 0.05), the MAP levels in group A at T1 and T2 were obviously higher compared with groups C and D ( $P$  < 0.05). The extubation time in group A was notably longer than that that in groups B, C, and D ( $P$  < 0.05), with longer extubation time in group B than that in groups C and D ( $P$  < 0.05). The orientation recovery time in group D was markedly shorter than that in groups A, B, and C ( $P$  < 0.05). The incidence of cognitive dysfunction, chills, and restlessness in groups C and D was notably lower compared with groups A and B ( $P$  < 0.05), with a higher incidence of chills, intraoperative hypotension, and delayed awakening in group D than in group C ( $P$  < 0.05). Conclusion. Dexmedetomidine at doses of 0.5 μg/kg and 0.8 μg/kg has a better effect in the maintenance of general anesthesia for patients with traumatic tibiofibular fractures, with faster orientation recovery, better recovery of postoperative cognitive function, and a lower incidence of adverse reactions. Dexmedetomidine at 0.5 μg/kg is recommended in view of the increased risk of excessive sedation, chills, restlessness, and intraoperative hypotension in patients at 0.8 μg/kg.