Clinical Research Of Dexmedetomidine Hydrochloride For Agitation Of Patients With General Anaesthesia

Objective:To investigate the efficacy and safety of dexmedetomidine treating for agitation of patients with general anaesthesia.Methods:Selected 120 cases of patients (ASAⅠ～Ⅱ) aged 20 to 55 years old, scheduled for general anesthesia of ENT, gastrointestinal glands surgery. According to whether applied DEX, patients were divided into experimental group (D group) and the placebo group (P group), and then according to the different ways of anesthesia, patients divided into the intravenous inhalation combined group (D1 group, P1 group), total intravenous group (D2 group, P2 group) and total inhalation group (D3 group, P3 group). In induction of anesthesia, P group:we used propofol with target controlled infusion (TCI), the target concentration was 4μg/ml. When patients lost consciousness, we used fentanyl 3μg/kg, Cisatracurium Besylate 0.2mg/kg for intubation. D group:We use 0.5ug/kg dexmedetomidine as loading dose infusion, continuous infusing for 10 minutes and then 0.5ug/kg/h for maintenance. Propofol's target concentration was 3～4μg/ml. when patients lost consciousness, we used fentanyl 3μg/kg, Cisatracurium Besylate 0.2mg/kg for intubation. According to different groups, maintenance of anesthesia divided into the intravenous inhalation combined group, total intravenous group and total inhalation group. Half an hour before the end of operation, stop using fentanyl and DEX. After surgery, patients were transferred to PACU. Recorded the patients'SBP, DBP, HR following five points: Physiological value of preoperative (To), immediately after withdrawal (T1), ten minutes to stop medication (T2), spontaneous breathing resumed (T3), suction extubation (T4). Recorded awakening time, extubation time, extubation quality assessment, ratio of postoperative agitation, patient agitation score, visual analog scale (VAS). Measurement data were expressed mean±standard deviation (x±s). SPSS 13.0 software was used for statistical analyses. Group at each time point were analyzed by ANOVA, two-sample t-test was used to compare the same time point between groups, count date were analyzed by x2 test, P<0.05 considered statistically significant difference.Results:Three DEX groups had no delirium, emergence agitation occurred. The incidence of cough in patients was low and consciousness was more clearly. Extubation qualities of D groups were also better than the P groups, and VAS scores of D groups were also lower than the P groups. The heart rates, blood pressure of D groups were more stable, closer to the baseline. Awakening time and extubation time between D groups and P groups were not statistically significant. Initial increase in blood pressure and a reflex decrease in HR can occur if injection of loading does is too fast, a very small number of patients after extubation may cause airway obstruction resulting from the fall tongue root.Conclusion:1.Dexmedetomidine can significantly reduce the incidence of emergence agitation patients under general anesthesia, and reduce cardiovascular responses to tracheal extubation.2.Initial increase in blood pressure and a reflex decrease in HR can occur if injection of loading does is too fast, a very small number of patients after extubation may cause airway obstruction resulting from the fall tongue root.