| Objective: Dexmedetomidine is a new type ofα2 adrenergic receptor agonist. An increasing number of studies have shown that dexmedetomidine in patients with general anesthesia can reduce the MAC values of inhaled anesthetics. Studies have shown that dexmedetomidine can reduce the inhalation induction of anesthesia in elderly patients with sevoflurane MAC values. But there was few of the study that intravenous induction of anesthesia, inhalation of sevoflurane to maintain general anesthesia in patients with dexmedetomidine on sevoflurane MAC value. So one of the purposes of this experiment is to explore in this regard and have a research on dexmedetomidine in patients with inhalation anesthesia in their MAC values of sevoflurane effects. Dexmedetomidine also has some impact on the depth of anesthesia in patients with general anesthesia. However, Some studies at home and abroad mainly use bispectral index (BIS) as an index. Using cerebral function monitor (CSM) for monitoring cerebral state index (CSI) was rarely reported, but it is good at the state of consciousness to reflect the difference between the conversion and forecast harmful to stimulate reaction and body movement than those in both cerebral state index and bispectral index sensitivity, and the reaction time shorter than the bispectral index of 10~20s. Therefore, the other purpose of this experiment is to study the impact of dexmedetomidine on general anesthesia in patients with CSI.Methods: Select 30 patients who are ASA I-II-class selective inhalation general anesthesia in surgery. All patients were randomly divided into two groups, D group (dexmedetomidine group, n=15), C group (0.9% NaCl solution control group,n=15), using double-blind controlled observation. D group: loading does of 0.4μg/kg dexmedetomidine (concentration 4μg/ml) and pumping it using micro-pump(pump speed 0.6ml/kg/h), then pumping the does of 0.4μg / kg/h dexmedetomidine continuous through intravenous pump (pump speed 0.1ml/kg/h); C group: 0.9% NaCl solution, 50ml. The same way with D group, first loading does of 0.9% NaCl solution (pump speed 0.6ml/kg/h) and pumping, then pumping the dose of 0.9% NaCl solution (pump speed 0.1ml/kg/h) continuous through intravenous pump. Both groups using midazolam 0.02mg/kg, vecuronium 0.1mg/kg, propofol 1.2mg/kg, sufentanil 0.4μg/kg during induction of intravenous pump. Started giving and stoped using nitrogen 3 min and then did endotracheal intubation. And then, connected to intermittent positive pressure ventilation anesthesia machine (IPPV). When patients got in the operating room(T0), drug pumps at the beginning (T1), drug pumps for 5 minutes (T2), drug pumps for 10 minutes (T3), drug pumps for 15 inutes (T4), open skin when the (T5), 5 minutes after cut the skin (T6 ), 10 minutes after cut the skin (T7), 15 minutes after cut the skin (T8), 20 minutes after cut the skin (T9), 30 minutes after cut the skin (T10), recorded the systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MBP), heart rate (HR), pulse oxygen saturation (SpO2), cerebral state index (CSI). After did endotracheal intubation, we also recorded the lowest record of sevoflurane alveolar concentration (MAC). All data were given by mean±standard deviation. Used SPSS statistical software for statistical processing. In the group, we used paired t test to compare the data and we used the Student t test to compare between the two groups. P <0.01 or <0.05 for the the difference was significant.Results: When D group and C group patients got into the operating room and when started pumping the drugs, the basic vital signs such as heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and cerebral state index (CSI) were no statistical significant difference(P> 0.05). But after pumping for 5 minutes(T2), 10 minutes(T3) and 15 minutes(T4), the systolic blood pressure, cerebral state index were statistical significantly decreased when compared with the data of drug pumps at the beginning (T1) for D group patients(P<0.05 or P<0.01), and also the diastolic blood pressure, heart rate were decreased too, but no statistical significance difference(P>0.05). There were no statistical significant changes for the C group patients as the data of D group patients(P>0.05). After cuting the skin, maintained CSI at 40±3, that was to say that maintain the same depth of anesthesia, there were no statistical significant difference between D group and C group patients with blood pressure, heart rate, (P>0.05). When maintained the CSI at 40±3, D group patients had sevoflurane MAC value of 1.10±0.12, while the C group patients had sevoflurane MAC value of 1.52±0.10, there were statistical significant difference between the two groups (P<0.01 ).Conclusion: Dexmedetomidine is a sedative, analgesic, anxiolytic and stable hemodynamics of a Newα2 adrenergic receptor agonist. Application of general anesthesia patients in dextral Dexmedetomidine can reduce CSI, to deepen the depth of anesthesia; and maintained at 40±3 CSI sevoflurane reduced the MAC value of about 27%, reducing the amount of sevoflurane.
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