Comparison of different doses of dexmedetomidine combined with remifentanil and propofol for an-esthesia in burn patients with non-intubation / 中华麻醉学杂志

ABSTRACT

Objective To compare the different doses of dexmedetomidine combined with remifen-tanil and propofol for anesthesia in the burn patients with non-intubation. Methods Sixty burn patients of both sexes, aged 18-64 yr, with body mass index of 19-24 kg∕m2 , of American Society of Anesthesiologists physical statusⅠorⅡ, scheduled for elective skin grafting with burn covering less than 10％ of the total body surface, tangential excision, or dressing change with burn covering 10％-50％ of the total body surface, were selected and divided into A, B and C groups using a random number table method, with 20 patients in each group. In A, B and C groups, dexmedetomidine 1. 0 μg∕kg was intravenously infused for 10 min at a constant rate, followed by an infusion of 0. 6, 0. 8 and 1. 0 μg·kg-1 ·h-1 , respectively, until 10 min be-fore the end of surgery. Remifentanil and propofol were given by target-controlled infusion via the dual chan-nel, the target plasma concentration of propofol was adjusted to maintain the index of consciousness at 40-60, and administration was stopped at the end of surgery in three groups. The development of respiratory depres-sion, body movement and hypotension was observed during operation. The consumption of remifentanil and propofol, emergence time and Ramsay sedation score at 1 h after operation were recorded. Results Com-pared with group A, the incidence of respiratory depression and consumption of propofol were significantly de-creased, and the rate of satisfaction with sedation was increased in B and C groups (P<0. 05), and the inci-dence of hypotension was significantly increased in group C ( P<0. 05) . The incidence of hypotension was sig-nificantly higher in group C than in group B ( P<0. 05) . There were no significant differences in the consump-tion of remifentanil or emergence time among three groups ( P>0. 05) , and no body movement was found in three groups. Conclusion Intravenously infused dexmedetomidine 0. 8 μg·kg-1 ·h-1 combined with remifentanil and propofol provides better efficacy when used for the burn patients with non-intubation.