Application of a low dose of dexmedetomidine during percutaneous kyphoplasty in the elderly patients / 中国医师进修杂志

ABSTRACT

Objective To explore the sedative effects of a low dose of dexmedetomidine (DEX) during percutaneous kyphoplasty (PKP) in the elderly patients.Methods Forty elderly patients with ASA grade Ⅱ-Ⅲ grade who scheduled PKP were divided into DEX group and control group by random digits table method,each group 20 cases.DEX group received an infusion of 0.5 μg/kg for 10 min before the operation,then the infusion speed was adjusted to 0.2 μ g/ (kg·h).An equivalent volume of 0.9％ sodium chloride was administered in control group.Systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate (HR),and pulse oxygen saturation (SpO2) were recorded at the beginning of DEX infusion (T0),10 min(T1),30 min(T2),60 min(T3) after DEX infusion and the end of operation (T4),Ramsay scores was also recorded.Results HR,SBP,DBP in DEX group at T1-T3 was significantly lower than that T0 and the same time in control group [(65.6 ± 14.6),(63.4 ± 10.2),(66.7 ± 10.5) times/min vs.(81.4 ± 11.2) times/min and (75.3 ±6.9),(72.8 ± 11.4),(73.8 ±9.6) times/min; (127.5 ± 10.2),(125.4 ± 12.6),(122.4 ±7.8) mm Hg(1 mm Hg =0.133 kPa) vs.(152.5 ± 11.8) mm Hg and(145.1 ± 10.6),(137.2 ± 11.3),(142.6 ± 8.8) mm Hg; (73.7 ± 8.9),(70.3 ± 9.9),(70.3 ± 11.5) mm Hg vs.(90.5 ± 11.0) mm Hg and(86.2 ± 11.6),(82.6 ± 10.9),(78.8 ±8.7) mm Hg,P ＜0.05].The Ramsay scores in DEX group at T1-T3 were significantly higher than those T0 and the same time in control group [(3.6 ± 0.8),(4.2 ± 0.8),(3.7 ± 0.5) scores vs.(2.0 ± 0.0)scores and (1.7 ± 0.6),(1.9 ± 0.4),(1.6 ± 0.5) scores,P ＜ 0.05].HR,SBP,DBP in DEX group at T4 was significantly lower than that T0,HR in DEX group at T4 was significandy lower than that in control group,difference was statistically significant(P ＜ 0.05).Bradycardia and applications vasopressors did not occur in two groups.There was no significant difference in SpO2 between DEX group and control group(P＞ 0.05).Conclusion It is both feasible and safe that sedative effect of a small dose of DEX during PKP in the elderly patients.