Abstract: Objective: To explore the application of intranasal dexmedetomidine at different doses in elderly patients during general
anesthesia. Methods: A total of 60 elderly patients undergoing elective surgery under general anesthesia at People's Hospital of Yuxi
City from January to September 2023 were randomly divided into three groups: Group A（ 0.5 μg/kg）, Group B（ 0.8 μg/kg）, and Group C
（1.0 μg/kg）, with 20 patients in each group. Intranasal dexmedetomidine was administered 30 minutes prior to anesthesia induction in all
groups. Mean arterial pressure （MAP）, heart rate （HR）, and rate pressure product （RPP） were measured at different time points.
Awakening time, extubation time, postanesthesia care unit （PACU） stay duration, extubation quality scores, Ramsay sedation scores,
and incidences of bradycardia were also compared. Results: In Group A, MAP, HR, and RPP were significantly increased during
induction intubation and tracheal extubation, with adverse reactions such as coughing during extubation. Groups B and C exhibited more
stable vital signs and higher extubation quality scores. Notably, the Ramsay sedation score in Group C was significantly higher than in
Groups A and B, but Group C also showed postoperative drowsiness and prolonged PACU stay. Conclusion: Administering intranasal
dexmedetomidine at 0.8 μg/kg 30 minutes prior to anesthesia induction effectively suppresses stress responses during intubation and
extubation in elderly patients undergoing elective general anesthesia. This dose demonstrates minimal adverse effects and is suitable
for clinical application in anesthesia management.

Key words: intranasal dexmedetomidine, elderly patients, general anesthesia