Analysis of Dexmedetomidine on the Quality of Awakening During Neurosurgery

Abstract Dexmedetomidine has a dose-dependent sedative and analgesic effect. To further evaluate the wake-up quality of dexmedetomidine in patients undergoing neurosurgery, a meta-analysis of dexmedetomidine in a randomized controlled trial of general anesthesia was performed. Firstly, an experimental algorithm was proposed, and then the data fusion algorithm was used to conduct randomized controlled trials. The clinical efficacy and safety of dexmedetomidine in the acupuncture of neurosurgical patients were evaluated one by one for quality evaluation and data extraction. The effect of different input variables on the depth of anesthesia was studied by using a multi-data fusion approach. The results show that the data fusion algorithm proposed can effectively connect redundant information and complementary information in multiple data, and estimate the real parameters of the measured object. In addition, data fusion brings great convenience to the design of control algorithms and controllers, and provides an effective basis for system simplification. Experiments have shown that dexmedetomidine is effective and safe in the operation of neurosurgical motor function, and the management of the recovery period is safe and effective. Based on the research, it can provide some reference for the awakening of patients undergoing neurosurgery, and promote the progress and development of medicine.


Introduction
A variety of new monitoring methods have been widely used in clinic with the rapid development of medicine, such as motor evoked potentials and functional magnetic resonance. However, these methods also have their limitations, such as brain shift caused by space-occupying lesions, signal interference, false positive rate, individual differences, etc [1].
Studies have shown that awakening patients during craniotomy is one of the effective ways for patients to avoid impaired important functions in functional areas. Neurosurgeons are still the first choice for craniotomy [2]. In functional neurosurgery, in order to improve the benefits of traumatic resection and reduce the risk of neurological dysfunction, patients often require neurophysiological tests during surgery to determine changes in the surgical site or expected function, which requires an anesthetic that should be sedated and analgesic [3]. Dexmedetomidine (Dex) is a special adrenergic receptor agonist with sedative, analgesic, antisympathetic, mild respiratory depression, and easy to wake up. These features offer the possibility of intraoperative anesthesia selection [4]. In this context, a study of the effect of dexmedetomidine on the quality of intraoperative wake-up in patients undergoing neurosurgery was developed.
Dexmedetomidine sets wake-up quality in patients undergoing neurosurgery were studied. Firstly, an experimental algorithm was proposed, and then a data fusion algorithm was used to conduct a randomized controlled trial to observe the clinical efficacy and safety of dexmedetomidine in the arousal quality of patients undergoing neurosurgery. Quality evaluation and data extraction were performed one by one. The method of data fusion studied the effects of different input variables on the depth of anesthesia. It effectively contacts the redundancy and complementary information in the multi-data, and estimates the real parameters of the measured object as much as possible.
The effect of dexmedetomidine on the quality of intraoperative wake-up in patients undergoing neurosurgery was investigated.
Firstly, the status quo of the research on the wake-up quality of dexmedetomidine and neurosurgery patients was expounded, in order to provide the theoretical basis for the following. Then the principle of quantitative inhalation anesthesia was analyzed, and the data fusion algorithm was proposed.
The characteristics, main principles and implementation flow of the algorithm are analyzed. Finally, the data fusion algorithm was tested, and the data was normalized, and the four signals of blood pressure, muscle relaxation, CO2 concentration and pulse were processed, and the experimental conclusion was obtained.

Related Work
In 1999, the US Food and Drug Administration approved the initial sedation of patients with mechanical ventilation in the 24-hour intensive care unit, and China has only begun to use dexmedetropine in recent years. Luo X et al believe that surgery for brain damage is likely to cause severe postoperative nerve damage.
How to accurately locate and remove lesions while ensuring normal neurological function is a problem faced by psychiatrists and mental health doctors [5]. Thongrong  and it is easy to cause increased intracranial pressure due to asphyxia and agitation [11]. As a novel, highly selective, adrenergic receptor agonist, dexmedetomidine has a variety of functions including dose-dependent sedation, analgesia, anxiety, inhibition of sympathetic nerves and brain protection.
Without respiratory depression, the receptor can excite the brainstem blue spot (awake and sleep), the most densely packed area of the central nervous system, responsible for mediating and maintaining a natural non-sleep state [12]. Similar to physiological sleep, it is easy to wake up and has fewer side effects. It is an ideal drug for awakening in functional neurosurgery. There are few domestic reports and it still needs to accumulate data.

Anesthesia method
Drinking alcohol was prohibited before surgery.
Fasting for 10 hours, local anesthesia was performed by radial artery puncture into the operating room, conventional ECG monitoring, and induction of central venous puncture.

Experimental design
The wake-up quality of dexmedetomidine in neurosurgery patients was studied.Firstly, an experimental algorithm is proposed, and then a randomized controlled trial is conducted using data fusion algorithm to observe the clinical efficacy and safety of dexmedetomidine in the wake-up quality of Neurosurgery patients.
The quality evaluation and data extraction are carried out one by one.In this paper, the effect of different input variables on anesthesia depth was studied by means of multi-data fusion. Effectively

Wake-up test
During the wake-up period, stop using other drugs, the agile and saline syringe pump is 0.2μg / (kg · h) to stay awake until the end. On both sides of the spine, artificial respiration should be performed every 30 minutes.
After the patient is awake, the patient is fully awakened and the anesthesia continues to be strengthened after the test. After the operation, the wake-up quality grading standard was evaluated with reference to [6].
It is mainly divided into four grades, level 1:

Statistical processing
The SPSS 17.0 tool was selected for research,

Research results
The blood flow dynamics of patients in group D were stable when they were awake, and the blood pressure and heart rate were stable when they were awake. Hemodynamic changes were significant at different time points in group N (P<0.05). The difference between the two groups was statistically significant (P<0.05).
There was no significant difference in the BIS values between the two groups during the awakening stage, as shown in Table 1 Table 4. There was a statistically significant difference in Ramsay sedation score between the two groups (P<0.05), as shown in Table 5. There was a statistically significant difference between the two groups in VAS score and postoperative satisfaction score (P<0.05), as shown in Table 6.  It can be seen from the results that the hemodynamics of patients in group D before and after waking were more stable than those in group N, which may be closely related to the sympathetic inhibition of dexmedetomidine.
Although the patient was able to wake up with agile D-group and low-dose injections at a constant rate, there was no significant difference in respiratory recovery time between the two groups, and there was no statistically significant difference. At the same time, it was also shown that the 0.2μg/(kg·h) pump injection agile calm did not cause the reaction of patients with respiratory depression, and it also demonstrated the Ard scholar study [14].
Awakening both groups of patients during the arousal quality grading period compared to nearly 90% of patients in group D were able to respond to the desired exercise after hearing the sound waking up. According to Ramsay's sedation score analysis, patients in group D were relatively calm and able to cooperate with surgery [15]. Anxiety and restlessness occurred  It is an ideal drug for awakening in functional neurosurgery.

Conclusion
With