ABSTRACT
Objective In laparoscopic cholecystectomy(LC), increased intra-abdominal pressure and carbon dioxide absorption may cause obvious sympathetic excitation and bring about increased blood pressure and heart rate. Effective control on such sympathetic responses can reduce complications, which is beneficial to timely recovery for patients. The study aimed to investigate the effect of different doses of dexmedetomidine on blood pressure, heart rate and postoperative sedation during perioperative period in patients undergoing LC.Methods Sixty patients enrolled in the study randomly were divided into three equal groups(20 patients each): control group(only equal amount of isotonic saline), low dose group and high dose group according to the injection of dexmedetomidine. At each time point including before anaesthesia(T0), before cutting(T1), pneumoperitoneum at 0min(T2), at 10min(T3), at 20min(T4), immediate deflation(T5), before extubation(T6), after extubation and before leaving operation room(T7), and entering recovery room(T8), records were made on the patient’s blood pressure, heart rate, SpO2, airway peak pressure, PetCO2 and Ramsay sedation score after extubation.Results Extubation time and PACU stay time were significantly longer in high dose group in comparison with control group and low dose group (F=12.669, P=0.000 and F=6.281, P=0.030 respectively). Compared with control group, the heart rates of high dose group and low dose group at T5, T7 and T8 decreased significantly(P<0.05). During T2-T5, airway peak pressure was significantly higher than those of control group and low dose group(P<0.05). At T7, the Ramsay score of high dose group was significantly higher than those of control group and low dose group(P=0.015).Conclusion Sustainable pumping of dexmedetomidine can keep stable heart rate. However, the increase of pumping rate and dose will deepen the depth of sedation after extubation and obviously extend extubation time and observation time in recovery room. Therefore, it is appropriate to infuse dexmedetomidine less than 0.5μg/(kg·h) in clinical anaesthesia.
ABSTRACT
Objective To evaluate the postoperative efficacy and safety of dexmedetomidine for cardiac surgery patients in intensive care unit. Methods A total of 90 cardiac surgery patients in the intensive care unit (ICU)were randomly assigned into dexmedetomidine group(D group,45 cases)and propofol group(P group,45 cases)to receive dexmedetomidine or propofol respectively for post-operative sedation. The ratio of sedation satisfac-tion was evaluated and calculated by Riker sedation-agitation scale(SAS),and the duration of mechanical ventila-tion,24-hour consumption of sufentanil,ICU staying time,and the incidences of side-effects(such as hypoten-sion,bradycardia,delirium etc)were recorded during the observation period. Results No significant differences were found in the ratio of sedation satisfaction and the incidences of bradycardia and delirium between the two groups (P > 0.05). The duration of mechanical ventilation and ICU staying time were significantly shorter in D group than that in P group(P<0.01),while the 24-hour consumption of sufentanil and the incidences of hypoten-sion and delirium were significantly lower than that in P group(P<0.05). Conclusion Using the dexmedetomi-dine as a postoperative sedation drug for post cardiac surgical patients in ICU is clinically effective and safe ,and the postoperative recovery of patients may be enhanced by the drug using.
ABSTRACT
Objective To explore the effect of dexmedetomidine combined with sevoflurane on the postoperative sedation for children undergoing ophthalmic operation.Methods Pediatric patients (200 cases) in Ankang Hospital of Traditional Chinese Medicine from January 2014 to August 2016 were enrolled,of which patients were divided into two groups randomly,Group A (n =100) accepted sevoflurane combined with normal saline,and Group B (n =100) adopted sevoflurane combined with dexmedetomidine.The operative conditions and postoperative VAS,Ramsay and PEAD scores were evaluated,and the postoperative adverse reactions were recorded and analyzed.Results There was no significance of the operation time between two groups,the wakened time of Group B was later than that of Group A significantly (P ＜ 0.05),the postoperative extubation quality score of Group B was lower than that in Group A (P ＜ 0.05),and the times of using analgesic in Group B was fewer than that of Group A (P ＜ 0.05);The VAS score of patients in Group B was significantly lower than that of Group A at the time points of T1,T2 and T3;At the time points ofT1 and T2,the Ramsay score of patients in Group B was higher than that in Group A,and PAED score of Group B was lower than that in Group A,with significant difference between Groups A and B (P ＜ 0.05);The incidence of nausea and vomiting,respiratory depression,postoperative agitation of patients in Group B was lower significantly than that of Group A,and the incidence of total adverse reactions in Group B was also lower than that in Group A significantly (P ＜ 0.05).Conclusion The clinical efficacy and safety of dexmedetomidine combined with sevoflurane for patients undergoing ophthalmic operation are remarkable and deserve popularization in clinic,which not only relieves the restlessness agitation of patients in recovery period,but also decreases the incidence of adverse reactions.
ABSTRACT
Objective To evaluate the effectiveness and safety of dexmedetomidine for the sedation of the patients after coronary artery bypass grafting (CABG).Methods The selective 96 CABG patients,ASA Ⅱor Ⅲ,aged 36 to 68 years old,58 males and 38 females,were randomly divided into 2 groups (n =48):dexmedetomidine group (group A) and midazolam group (group B).Group A patients received Dexmedetomidine (1.0 μg/kg)over 10 min,followed by 0.2-0.7 μg · kg-1 · h-1 to maintain sedation,whereas the other group patients received midazolam (0.05 mg/kg) over 10 min,followed by 0.02-0.10 mg · kg-1 · h-1 to maintain sedation.Two groups of patients stopped using drug when they were fit off-line and extubation.Observe the percentage of time within target sedative scope (Riker range 3-4),the changes of vital signs before and after treatment,the prevalence of delirium,the awakening time,the duration of mechanical ventilation,ICU length of stay,the adverse events of blood pressure and heart rate.Results There were no significant difference in the percentage of time within target sedative scope between two groups (75.5％ for dexmedetomidine group vs 74.6％ for midazolam group,P ＞ 0.05).Compared to midazolam group,the Dexmedetomidine group has a shorter awakening time [(14.0 ± 6.2) min for dexmedetomidine group vs (50.4 ± 12.8) min for midazolam group,P ＜ 0.05] and duration of mechanical ventilation,and also the prevalence of delirium was lower(15.3％ for dexmedetomidine group vs 34.6％ for midazolam group,P ＜0.05).ICU length of stay was similar.Dexmedetomidine-treated patients were more likely to develop bradcardia,with a non significant increase in the proportion requiring treatment,but had a lower likelihood of tachycardia or hypertension requiring treatment.Conclusion Dexmedetomidine is safe and effective in patients after CABG surgery.