ABSTRACT
Objective To investigate the effects of dexmedetomidine on the end-tidal concentration of sevoflurane during recovery from breast cancer surgery under general anaesthesia. Methods A total of 120 patients undergoing unilateral breast cancer radical operation were randomly divided into four groups:group C (infusion of saline, n=30), group D0.5 [infusion of dexmedetomidine 0.5μg/(kg·h) during operation, n=30], group D0.6 [dexmedetomidine 0.6μg/(kg·h), n=30] and group D0.7 [dexmedetomidine 0.7 μg/(kg · h), n=30]. The end-tidal concentrations of sevoflurane during surgery and postoperation were observed. The end-tidal concentration of sevoflurane on palinesthesia was recorded. The time from stopping administration of anesthetic drug to palinesthesia and the operation time were recorded. The palinesthesia of patients from general anaesthesia and the degree of emergence agitation of the patient were measured using Riker ’s sedation-agitation scale. The operation time, anesthesia time, intraoperative remifentanil dosage, intraoperative auditory evoked potential index (AAI), sevoflurane inhalation concentration and the corresponding time were recorded. Results There were no significant differences in clinical data, remifentanil dosage, operation time and AAI between four groups. The anesthesia time was longer in group D0.7 than that in the other three groups (P7 was lower in groups D0.5, D0.6 and D0.7 (P4 was significantly higher in group D0.6 and group D0.7 than that in group C and group D0.5, but the ratio of score>6 was lower (P3 was higher in group D0.7 than that of other three groups (P<0.05). Intraoperative cardiac tachycardia was found in group D0.6 and group D0.7 (4 cases, 13%and 8cases, 7%). Conclusion Sevoflurane inhalation anesthesia and intravenous infusion of dexmedetomidine 0.6μg/(kg·h) can effectively reduce intraoperative sevoflurane dosage, the end-tidal concentration of sevoflurane during recovery, and the occurrence of agitation in patients undergoing general anesthesia.
ABSTRACT
ObjectiveTo explore two different anesthesia methods on hemodynamics and the quality of palinesthesia in elderly patients during peroperative period.Methods Sixty elderly patients with Hip Replacement( ASA,Ⅰ,Ⅱ ) were randomly divided into general anesthesia group ( group A,n =30 ) and combined general and epidural anesthesia group( group B,n =30).The changes of mean arterial pressure(MAP)and heart rate( HR ) were monitored before induction of anesthesia( T1 ),at intubation( T2 ),during skin incision (T3) and at the time of extubation ( T4 ),at 30 min after extubation ( T5 ) and at the same time,the dosage of general anesthetics and each index's time after operation to awake were recorded of the patients in both groups.ResultsThe MAP and HR of patients in two groups at T2,T3,T4,T5 were all increased when compared with T1.And the increasing degree of MAP and HR in group A were higher than that in group B ( MAP:within group F =17.352,interaction F =4.326,between groups F =8.652; HR:within group F =11.561,interaction F =5.241 between groups F =7.248; P ＜ 0.05 ).The dosage of general anesthetics was significantly different between two groups[ sevoflurane:(1.40 ± 0.30)MAC vs (1.00 ± 0.12 )MAC,t =0.37,P＜0.05 ; fentanyl:(0.34 ±0.08)mg vs(0.18 ±0.03) mg,t =0.21,P ＜0.05 ; vecuronium:(6.20 ±0.32) mg vs(4.10 ±0.31 ) mg,t =1.24,P ＜0.05 ; propofol:(448 ±24) mg vs(393 ±26) mg,t =3.46,P ＜0.05].There was significant difference on gag reflex time [ ( 18.00 ± 1.27 ) min vs ( 12.31 ± 2.54 ) min,t =2.74,P ＜ 0.05 ],time to extubation [ ( 24.03 ± 2.42 ) min vs ( 16.05 ± 1.20 ) min,t =3.68,P ＜ 0.05 ],fully awake time [(29.54±5.24)min vs(19.25±2.64)min,t=1.35,P＜0.05] between these two groups.ConclusionThe two different anesthesia methods can ensure haemodynamic stability of elderly patients undergoing hip replacement during peroperative period.But compared with general anesthesia group,combined general and epidural anesthesia group can reduce the dosage of general anesthetics and shorten the time of extubation significantly,it is a viable and an ideal method.