Application of Dexmedetomidine for Endovascular Stent Graft Exclusion for Aortic Dissection / 中国微创外科杂志

ABSTRACT

Objective To evaluate the efficacy and safety of dexmedetomidine applied in the endovascular stent graft exclusion for aortic dissection . Methods From January 2015 to December 2016, 82 patients with type DeBakey Ⅲ aortic dissection in our hospital were divided into either experimental group or control group according to random number table .In the experimental group, patients were given 15 min infusion of dexmedetomidine at 1 μg/kg, followed by 0.3 μg· kg-1 · h-1 continuous infusion .In the control group , patients were given propofol infusion at 4-6μg· kg-1 · h-1 combined with target controlled infusion of remifentanil at 3-5 μg/L.The two groups were operated under local anesthesia .The Ramsay score, MAP, and SpO2 were observed at baseline time ( T0 ) , anesthesia induction ( T1 ) , skin cut ( T2 ) , and accomplishment of surgery ( T3 ) . Results The Ramsay scores of the experimental group were lower than those of the control group at T 0, T1, T2, and T3[T0(1.8 ±0.4) points vs.(2.1 ±0.6) points, t=2.664, P=0.009;T1(2.8 ±0.3) points vs.(5.1 ±0.4) points, t=29.454, P=0.000;T2(3.0 ±0.5) points vs.(4.8 ± 0.3) points, t=19.766, P=0.000; T3 (2.9 ±0.4) points vs.(3.9 ±0.6) points, t=8.880, P=0.000].The MAP of the experimental group was higher than that of the control group at T 1[(76.2 ±10.1) mm Hg vs.(67.2 ±11.4) mm Hg, t=-3.784, P=0.002],and there was no significant difference at other timepoints between the two groups (P >0.05).The SpO2 of the experimental group at T0, T1, and T2 were higher than those of the control group [T0 (96.0 ±1.0)% vs.(95.0 ±1.5)%, t=-3.552, P=0.000;T1(95.5 ±1.1)% vs.(90.0 ±1.5)%, t=-18.933, P=0.000; T2 (95.0 ±1.3)% vs.(90.8 ± 1.1)%, t=-15.792, P=0.000].There was no significant difference in SpO 2 at T3 between the two groups(t=0.220,P=0.827).Conclusion Dexmedetomidine can be used safely in aortic dissection stent graft exclusion .