Clinical study of dexmedetomidine in digital subtraction angiography / 中国医师进修杂志

ABSTRACT

Objective To observe the sedative effectiveness of dexmedetomidine (DEX) in digital subtraction angiography (DSA),and to investigate the optimal and safe administration dose.Methods Seventy-five patients undergoing DSA were divided into three groups by random digits table with 25 cases each group.Three groups were treated with constant infusion of DEX by micro-pump 10 min before surgery with the same dose of saline.Then group A,B,C respectively were given 0.3,0.5,0.7 μg/ (kg·h) of the maintenance infusion rate,and stop infusion 10 min before the end of the surgery.At administration (T0),10 (T1),20 (T2) and 30 (T3) min after administration,10 min after surgery (T4),the heart rate (HR),mean arterial pressure (MAP),peripheral oxygen saturation (SpO2),Ramsay score,number of cases that appeared body movement were recorded,and their forgotten degree of operating memory were compared.Results The HR,MAP in three groups at T1-T3 was significandy lower than that at T0 (P＜ 0.05),T4 levels returned to T0 (P＞ 0.05).The HR,MAP in group C at T2,T3 was significantly lower than that in group A and group B at the same time (P ＜ 0.05).The Ramsay score in three groups at T2,T3 was significantly higher than that at T0(P ＜0.05),group B and group C at T2,T3 was significantly higher than that in group A at the same time (P ＜0.05).The SpO2 in three groups at each time point compared within and among groups was no significant difference (P ＞ 0.05).Group B and group C intraoperative involuntary movement in response patients were significantly less than in group A (5,3 cases vs.10 cases).Group A and group C surgery requires intervention patients was significantly more than in group B (8,10 cases vs.3 cases).Group B and group C amnesia grade Ⅲ rate was significantly higher than that in group A [64％ (16/25),72％ (18/25) vs.40％(10/25),P ＜ 0.05].Conclusion Infusion with 0.5 μ g/(kg· h) DEX 10 min after intravenous injection with 0.5 μ g/kg can get a better sedative effect,stable vital signs and less intraoperative adverse memory,and it can also improve patients' comfortable degree,which is safe and appropriate sedative dosage in DSA.