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Objective To investigate effect of dexmedetomidine on safety,validity and superiority in patients undergoing scoliosis surgery under propofol sufentanil anesthesia.Methods Forty patients undcrgoing elective posterior scoliosis surgery were randomly divided into groups D and C (n =10 each).Dexmedetomidine 0.8 μg/kg followed by 0.2 μg/(kg · h) and equal volume were infused at the 10 min before anesthesia induction in two groups,respectively.Hemodynamic parameters were observed at the 10 min before anesthesia induction (T1),3 min (T2) after anesthesia induction,1 min (T3) after intubation,at the beginning of wake-up test (T4),at the end of the test (T5),and 6 min (T6) after deepen anesthesia,respectively.Meanwhile the wake-up time,hemodynamic parameters,success rate of arousal,incidence agitation,and the bleeding volume during the test were also recorded.Results Successive rate of arousal awakening time between two groups had no statistical significance (P ＞ 0.05).Less incidence of agitation was found in group D compared to group C (P ＜ 0.05).The bleeding volume during the test was significantly less in group D (P ＜ 0.05).The hemodynamics was more smoothly during the operation in group D compared to group C (P ＜ 0.05).Conclusions Dexmedetomidine auxiliary propofol and sufentanil anesthesia can effectively implement intraoperative wake-up,reduce the amount of bleeding,and the incidence of agitation during the wake-up.The hemodynamics was more smoothly.
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Objective To explore effect of different withdrawal time of dexmedetomidine (DEX) on the quality of general anesthesia recovery.Methods Eighty patients of ASA Ⅰ or Ⅱ undergoing lymph surgery were randomly assigned to four groups (n =20).Groups D1,D2 and D3 received DEX 0.5 μg/kg as bolus before induction,continued with 0.5 μg/(kg · h) by infusion until one hour,30 min before the end of operation and the end of operation,respectively.Group C received equal volume of normal saline.Mean artery pressure (MAP),heart rate (HR) and pulse oxygen saturation (SpO2) were observed during and after operation.Spontaneous respiration recovery time,eyes open time,extubation time,orientation recovery time,observer's assessment of alertness/sedation score (OAA/S),restlessness score (RS),and visual analogue scales (VAS) were observed after operation.Results For MAP and HR in Groups D2 and D3,there were no statistically significant difference during extubation compared to those at preoperation,but at the same time point,they were lower than those in group C (P ＜ 0.05).For groups C and D1,MAP and HR at extubation and 5 min after extubation were higher than those at preoperation (P ＜0.05).Spontaneous respiration recovery time,eyes open time,extubation time,orientation recovery time in group D3 were significantly longer than those in Group C (P ＜ 0.05),while there were no statistically significantly difference between groups D1,D2,and group C.OAA/S in group D3 was significantly lower than that in group C (P ＜ 0.05) at extubation.Incidence of restlessness,VAS,and cases given analgesic 2 hours after operation in groups D2 and D3 were significantly lower than those in groups C and D1.Compared to those in group C,dosages of propofol and remifentanil in groups D2 and D3 were significantly lower.Conclusions Dexmedetomidine administered of 0.5 μg/kg before induction,continued with infusion of 0.5 μg/(kg · h) until 30 min before the end of operation,may improve emergence,without influencing the awakening time of patients,and prolong the duration time of analgesia which comfort the patients.
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Objective To investigate the clinical efficacy and safety of dexmedetomidine combined with sevoflurane in elderly patient undergoing percutaneous nephrolithotomy.Methods Forty ASA Ⅰ ～ Ⅱ elderly patients of both sexes,aged 65 ～ 76 (71.0 ± 6.0)yr,scheduled for elective surgery of percutaneous nephrolithotomy under general anesthesia,were randomly divided into two groups (n =20 each):dexmedetomidine/sevoflurane group (group D) and propofol/sevoflurane group (group P).All patients received fentanyl,propofol,and cisatracurium for anesthesia induction.After endotracheal intubation,patients in group D received an initial loading dose of 0.5 μg/kg (4 μg/ml) of dexmedetomidine over 10 min,followed by a continuous infusion of 0.3 ～ 0.6 μg/(kg · h).Patients in group P received an initial loading dose of 1 mg/kg of propofol over 10 min,followed by a continuous infusion of 3 ～ 6 mg/(kg · h).All patients received the inhalation of sevoflurane for maintenance.Bispectral index was used to maintain a similar level of hypnosis in both groups (40 ～ 60).The heart rate (HR),blood pressure (BP) [systolic blood pressure (SBP)/diastolic blood pressure (DBP)],oxygen saturation (SpO2),end-tidal carbon dioxide partial pressure (PETCO2) at different time points before anesthesia (T0),10 min after prone position (T1),30 and 60 min started lithotripsy (T2-3),and at the end of operation (T4) were recorded,respectively.The operation time,amount of blood loss,and volume of fluid infusion were recorded.Recovery time of spontaneous ventilation,awaking time (open eyes by calling),extubation time,staying time at postanesthesia care unit (PACU),and relevant complications were also recorded.Results Compared to the baseline value at T0,SBP and DBP were significantly decreased at T1 in both groups(P ＜0.05),and no significant differences in the SBP,DBP,SpO2,and PETCO2 were found between two groups(P ＞ 0.05).Compared to the baseline value at T0,the HR was significantly decreased at T1 ～ T4 in group D (P ＜ 0.05),the HR was significantly lower at T1 ～ T4 in group D than that of group P (P ＜ 0.05).No significant differences in operation time,amount of blood loss,and volume of fluid infusion were found between two groups (P ＞ 0.05).No significant differences in recovery time of spontaneous ventilation,staying time at PACU,nausea,vomit,and agitation were found between two groups (P ＞ 0.05),while awaking time and extubation time were significantly longer in group D than that of group P(P ＜ 0.05).The shivering was significantly less in group D than that of group P (P ＜ 0.05).Conclusions Both dexmedetomidine/sevoflurane and propofol/sevoflurane anesthesia are suitable for elderly patients undergoing percutaneous nephrolithotomy.Dexmedetomidine/sevoflurane makes time of awake and extubation longer,but dexmedetomidine can reduce the shivering and the attendant complications caused by shivering.
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Objective To investigate the safety of the application of dexmedetomidine in patients with heart failure .Methods The selective cardiac surgery 80 patients with heart failure were randomly divided into two groups ( n =20 each):group I:0.5 μg/kg dexmedetomidine intravenous injection in 10 min;and group II:control group.Systolic blood pressure (SBP), diastolic blood pres-sure (DBP), heart rate (HR), oxygen saturation (SpO2), and bispectral index (BIS) were recorded at 10, 20, 30 min after injec-tion.Cardiac output (CO) and stroke volume variation (SVV) were also recorded at the time after radial artery and internal jugular vein puncture , and Ramsay and visual analogue scale ( VAS) score were also given to each patients of two groups at 30 min.Results The SBP, DBP, HR, and BIS of group I were lower than group II at 10 and 20 min after injection ( P <0.05 ); the SBP, DBP, HR, and BIS of group I were also lower than group II at the time after radial artery and internal jugular vein puncture [ SBP:(124.9 ± 15.5)mmHg vs (138.7 ±17.8)mmHg;(128.9 ±17.8)mmHg vs (140.3 ±19.3)mmHg, P <0.05;DBP:(69.4 ±10.2)mmHg vs (80.1 ±11.2)mmHg;(70.5 ±11.8)mmHg vs (87.7 ±13.6)mmHg, P <0.05;HR:(65.3 ±9.4)bpm vs (78.8 ±10.9)bpm;(68.2 ±10.8)bpm vs (80.9 ±13.3)bpm, P <0.05;BIS:84.5 ±5.7 vs 95.4 ±3.7;87.8 ±7.7 vs 95.3 ±4.7, P <0.05]; The CO, SVV, and SpO2 were no difference between two groups;the Ramsay(3.4 ±1.5 vs 1.2 ±0.4;3.9 ±1.7 vs 1.4 ±0.5) and VAS (2.1 ±0.7 vs 3.8 ±2.1;1.9 ±1.5 vs 4.1 ±2.1)score of group I were lower than group II ( P <0.05).Conclusions A amount (0.5 μg/kg) of dexmedetomidine intravenous injection can be safely used in patients with heart failure .