Abstract:

Objective

To explore the sedative and analgesic effect of combining dexmedetomidine with lidocaine cream during recovery period after tracheotomy in oral and maxillofacial tumor surgery.

Methods

Sixty patients who needed to get tracheotomy after oral and maxillofacial tumor surgery were randomly divided into three groups. When suturing incision， dexmedetomidine at 0.5 μg/kg in Group R and D， and saline in Group N were administrated intravenously for 30 minutes. When replacing the tracheal tube in tracheotomy， Group R was smeared by lidocaine cream on the surface of the tracheal tube. Coughing， dysphoria， recovery time， MAP， HR and RR were recorded. SPSS 17.0 software package were used for data processing.

Results

There was no significant difference in recovery time among the three groups （P=0.266）. Times of adding fentanyl and cases of SpO₂ declining below 90%after adding fentanyl in Group R were obviously fewer than those in Group D and Group N （Group D：χ²=7.619，P=0.006，χ²=8.547，P=0.003；Group N：χ²=25.600，P＜0.05，χ²=24.000，P＜0.05）， while those in Group D were also obviously fewer than those in Group N （χ²=7.619，P=0.006；χ²=6.995，P= 0.008）.During recovery time， there were no significant changes of Rass score， coughing score， HR， MAP or RR in Group R （P＞0.05）， while those in Group D and Group N changed a lot along with adding fentanyl （P＜0.05）， especially in Group N （P＜0.05）.

Conclusion

Dexmedetomidine combining with lidocaine cream is effective in attenuating coughing， dysphoria and hemodynamic changes during recover period for patients undergoing tracheotomy after oral and maxillofacial tumor surgery. Besides， it do not extend the recovery period.

Key words: Dexmedetomidine, Lidocaine cream, General anesthesia recovery period, Tracheotomy, Sedation, Analgesia