Functional Magnetic Resonance Imaging of Brain Function and Emergence Agitation of Patients with Dexmedetomidine-Assisted General Anesthesia under Comfortable Nursing Intervention

Abstract

In order to explore the effects of dexmedetomidine (DEX) on functional magnetic resonance imaging (fMRI) and emergence agitation of patients who underwent general anesthesia surgery with sevoflurane under comfortable nursing intervention, 66 patients who received upper abdominal surgery were selected as research objects. According to nursing and anesthesia methods, the patients were randomly divided into control group (routine nursing and anesthesia), group A (routine nursing and DEX-assisted anesthesia), and group B (comfortable nursing and DEX-assisted anesthesia). The differences in the brain fMRI characteristics, hemodynamic indexes, anesthesia recovery indexes, and nursing satisfaction in the perioperative period were evaluated. The results showed that the regional homogeneity values were different in different brain regions, but there was no difference in the Z value of functional connectivity(P > 0.05). Compared with the control group, heart rate, mean arterial pressure, awakening time, extubation time, the Riker sedation-agitation scale (SAS) score, and anesthetic dosage were signally decreased in group A and group B, while the Ramsay scores, the postanesthesia care unit (PACU) stay, and anesthesia maintenance time in the two groups was obviously increased(P < 0.05). Compared with group A, the extubation time, the SAS score, PACU stay, and hospital stay were all remarkably reduced in group B, while the nursing satisfaction score was greatly increased(P < 0.05). To sum up, DEX was helpful to safely and effectively reduce the occurrence of emergence agitation in patients under general anesthesia surgery with sevoflurane. Besides, comfortable nursing intervention could further reduce the incidence of emergence agitation in patients with general anesthesia, shorten the length of hospital stay, and improve nursing satisfaction.

Figure 1

Analysis of patients' brain fMRI and functional connectivity. (a) Patients' brain fMRI images, in which the red t-value expressed the positive number and the blue t-value expressed the negative number, the horizontal images were −30 mm, −20 mm, −10 mm, +0 mm, +10 mm, and +20 mm from left to right; (b) the functional connectivity Z value of the prefrontal lobe; (c) the functional connectivity Z value of the temporal lobe; (d) the functional connectivity Z value of hippocampus.

Figure 2

Changes in HR at different time points. ∗: compared with group A, P < 0.05; #compared with group B, P < 0.05.

Figure 3

Changes of MAP at different time points. ∗: compared with group A, P < 0.05; #compared with group B, P < 0.05.

Figure 4

Comparison of evaluation indexes of anesthesia recovery among three groups. (a) The waking time; (b) the extubation time; (c) Ramsay's score; (d) SAS score; (e) PACU residence time; (f) maintenance time of anesthesia.  ^∗: compared with the control group, P < 0.05; #compared with group A, P < 0.05.

Figure 5

Comparison of the usage amount of anesthetic drugs among three groups. (a) dosage of remifentanil; (b) dosage of sevoflurane.  ^∗Compared with the control group, P < 0.05.

Figure 6

Comparison of hospital stay and nursing satisfaction among three groups. (a) Length of hospital stay; (b) nursing satisfaction score.  ^∗Compared with the control group, P < 0.05; #compared with group A, P < 0.05.