Comparison of sedative efficacy of BIS-guided dexmedetomidine and propofol in elderly patients undergoing kyphoplasty / 中华麻醉学杂志

ABSTRACT

Objective:To compare the sedative efficacy of bispectral index (BIS)-guided dexmedetomidine and propofol in the elderly patients undergoing percutaneous kyphoplasty (PKP).Methods:Sixty elderly patients of both sexes, aged 70-90 yr, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, scheduled for elective PKP with local infiltration anesthesia, were divided into 2 groups ( n=30 each) using a random number table method: dexmedetomidine group (group D) and propofol group (group P). In group D, dexmedetomidine was infused for 10 min in a loading dose of 0.5 μg/kg followed by an infusion of 0.2-0.7 μg·kg -1·h -1 for maintanence.In group P, propofol was injected in a loading dose of 1.0 mg/kg followed by an infusion of 1-2 mg·kg -1·h -1 for maintanence.Local infiltration anesthesia was performed with 1% lidocaine 20-30 ml after disinfection and layering.The target BIS value was mainatined at 80-90.On admission to the operating room (T 0), at puncture (T 1), after balloon dilation (T 2), at the end of bone cement injection (T 3), and at the end of surgery (T 4), Ramsay sedation score was recorded, and the occurrence of adverse reactions such as hypotension, respiratory depression, bradycardia, nausea and vomiting was recorded during operation. Results:Compared with group P, the Ramsay score was significantly decreased, the incidence of bradycardia was increased, and the incidence of respiratory depression was decreased at T 1-4( P<0.05), and no significant change was found in hypotension and nausea and vomiting in group D ( P>0.05). Conclusion:Dexmedetomidine provides better sedative efficacy than propofol, but the occurrence of bradycardia should be prevented in the elderly patients undergoing PKP.