Clinical value of dexmedetomidine attenuating hemodynamic fluctuation in patients with cerebral aneurysm during anesthesia induction / 中国医师进修杂志

ABSTRACT

ObjectiveTo investigate the application of dexmedetomidine attenuating hemodynamic fluctuation in patients with cerebral aneurysm during anesthesia induction.Methods Sixty patients undergoing elective interventional procedure with cerebral aneurysm were divided into low dose of fentanyl group (group LF),high dose of fentanyl group (group HF),and low dose of fentanyl and dexmedetomidine combination group(group FD) by random digits table method with 20 cases each.Before induction of anesthesia,the patients in group FD received dexmedetomidine 1 μ g/kg for 10 minutes,and the others received 0.9％ sodium chloride with the same volume.During anesthesia induction,fentanyl 3 μ g/kg in group LF and group FD,and fentanyl 5 μ g/kg in group HF.Other anesthetics were equalized.Systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart rate (HR) were monitored and recorded at 3 min utes after lying on table (T0),before intubation (T1),immediately and 3 minutes after intubation (T2,T3).The differences between the maximum and the minimum of SBP,DBP and HR were calculated in these time points as fluctuation values,named as △SBP,△DBP and △HR.Results△SBP,△DBP and △HR in group FD [ (26.9 ± 14.8) mm Hg( 1 mm Hg =0.133 kPa),(10.7 ± 8.9) mm Hg,(12.5 ± 4.3 ) times/min ]were lower than those in group LF [ (40.4 ± 15.6) mm Hg,(20.3 ± 9.4) mm Hg,(30.1 ± 15.0) times/min ](P ＜ 0.05 ),as well as △SBP and △HR in group HF [ (29.8 ± 16.8 ) mm Hg,( 19.5 ± 7.4) times/min ]were lower than those in group LF(P ＜ 0.05).While △HR in group FD was lower than that in group HF (P ＜0.05).The usage of atropin in three group had no statistical significance during anesthesia induction (P =0.364),but more ephedrine was used in group HF than in group LF [30％(6/20) vs.5％(1/20),P=0.032 ].Conclusion Dexmedetomidine 1μ g/kg injected before anesthesia induction,which could prevent intubation reaction,blood pressure serious falling after intubation,and provide more stable hemodynamics,is particularly applicable for anesthesia induction in patients with cerebral aneurysm.