ABSTRACT
Objective To assess the accuracy of bispectral index (BIS) in monitoring the sedation level with dexmedetomidine combined with small-dose of sufentanil.And, to analyze the BIS value of the best opportunity for invasive manipulation with this sedation method.MethodsEighty elective operation patients, ASA Ⅰ~Ⅱ, were randomLy selected for the study.Before the start of anesthesia, small-dose of sufentanil 0.1μg/kg and dexmedetomidine were injected in vein in sequence.The loading dose of dexmedetomidine was 1.0μg/kg for 15 min and the maintenance dose was 0.3μg/kg for 5 min.The time-pint before the start of injection was recorded as T0.And, T1, T2, T3, and T4 respectively presented the infusion time of dexmedetomidine for 5min, 10min, 15min and 20min.According to these four time-points, 80 patients were randomLy divided into four groups: group T1, group T2, group T3,and group T4.The relevant HR, MAP, SpO2, BIS value, and OAA/S score were separately recorded.Analyze the correlation of BIS and OAA/S score, and the cutoff value of BIS for OAA/S score=1 was obtained by analyzing receiver operating characteristic (ROC) curve.ResultsThe compound use of dexmedetomidine and sufentanil significantly decreased HR.With this sedation method, BIS value was positively correlated with OAA/S score (r=0.95), and the best cutoff value of BIS values for OAA/S score=1 was 44.5.ConclusionThere was a good correlation between BIS and OAA/S score in monitoring sedation with dexmedetomidine combined with small-dose of sufentanil.BIS=44.5 could be regarded as a good monitoring index of invasive manipulation with this sedation method.
ABSTRACT
Objective To investigatethe EC50 of different doses of dexmedetomidine on etomidate inhibited responses tolaryngeal maskinsertion in patients.Methods 88 with breast cancerfrom surgical department in Zhuji Hospital of Traditional Chinese Medical from August 2014 to August 2015were selected and randomly divided into the control group(groupA)and the experiment group(group B1,group B2 and group B3)with 22 casesin each group,respectively,intravenous pump 0.9％sodium chloride solution and DEX(dose followed by 0.3,0.6,0.9μg/kg).The next sequential intravenous infusion of etomidateafter 10 min.The EC50 and the 95％confidence interval of etomidate were determined by sequential method in each group of patients,the changes of vital signs and adverse reactionsin patients were monitored.Results Four groups of patients with LMA EC50 and 95％confidence interval of etomidate respectively:0.78(0.723～0.835)μg/mL in group A,0.66(0.612～0.711)μg/mL in group B1,0.58(0.532～0.627)μg/mL in group B2,0.46(0.416～0.521)μg/mL in group B3.Four groups of patients with laryngeal mask insertion immediately before MAP and HR were lower than the baseline value,the difference was statistically significant(P<0.05),but the LMA elevated after one min.The control group of four patients with respiratory depression,three cases of patients with bradycardia in group B3,two cases of patients with hypotension were improved after symptomatic treatment.Conclusion In a certain range,increasing the dose of dexmedetomidine reduces the effective concentration of etomidate,which inhibits the laryngeal mask placement reaction.