Application of dexmedetomidine on patients with pancreatic cancer treated by high intensity focused ultrasound under general anesthesia / 中国医师进修杂志

ABSTRACT

Objective To investigate the effect of dexmedetomidine on patients with pancreatic cancer treated by high intensity focused ultrasound (HIFU) under general anesthesia.Methods One hundred and twenty ASA Ⅱ or Ⅲ patients with pancreatic cancer undergoing HIFU treatment,were divided into control group (group C) and dexmedetomidine group (group D) by random digits table method,each group with 60 cases.Dexmedetomidine was intravenously infused at 0.2 μ g/(kg· h) until the end of operation after a loading dose of 0.7 μg/kg over 15 min before induction of anesthesia in group D,while the equal volume of normal saline was infused in group C.Anesthesia was induced with intravenous injection of fentanyl 2-3 μg/kg and propofol 1.5-2.0 mg/kg and cisatracurium 0.2 mg/kg at 5 min after administration of the loading dose.Anesthesia was maintained with sevoflurane,remifentanil,propofol,cisatracurium.The propofol,remifentanil and sevoflurane consumption,the incidence of postoperative agitation,delirium,delayed recovery were recorded.Results The intraoperative heart rate in group D was significantly lower than that in group C (P ＜ 0.05).The propofol,remifentanil and sevoflurane consumption in group D were significantly shorter than those in group C [(341.4 ± 45.7) mg vs.(520.5 ± 50.8) mg,(1.7 ± 0.5) mg vs.(2.3 ± 0.8) mg,(11.6 ± 4.1) ml vs.(16.7 ± 3.8) ml,P ＜ 0.05].The incidence of postoperative agitation and delirium in group D were significantly lower than those in group C [6.7％(4/60) vs.21.7％(13/60),8.3％ (5/60) vs.26.7％ (16/60),P ＜ 0.05].There was no statistically significant difference in the incidence of delayed recovery between group D and group C [3.3％ (2/60) vs.1.7％ (1/60),P ＞ 0.05].Conclusions Dexmedetomidine given HIFU treatment of pancreatic cancer patients can reduce the amount of general anesthetic,reduce the incidence of postoperative agitation and delirium,intraoperative heart rate.