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The Influence Of Different Doses Of Dexmedetomidine On Hemodynamic And Effect Of Propofol Given By Target-controlled Infusion

Posted on:2012-07-01Degree:MasterType:Thesis
Country:ChinaCandidate:J ZhangFull Text:PDF
GTID:2154330335991552Subject:Anesthesia
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Objective:To investigate the influence of different doses of dexmedetomidine on hemodynamic and concentration of propofol given by target-controlled infusionMethods:Sixty ASAⅠorⅡpatients, BMI 18-25kg/m2,aged 18-65 year undergoing elective upper abdominal operation under general anesthesia were randomly divided into control group (group C) and observation group (group D). Observation group were divided into D1 (0.25μg/kg), D2 (0.5μg/kg), D3 (1.0μg/kg) with doses of dexmedetomidine,15 cases each. Before 10min in induction of anesthesia, we gave respectively 10 ml intravenous saline and different doses of dexmedetomidine (diluted with saline to 10mL).After infusion, anesthesia was induced with target-controlled pump (Grasby) infusion of propofol, according to the initial effect-site concentration of propofol set 1.5μg/ mL, increased 0.3μg/mL every 1min, remifentanil was then infused at 0.2μg·kg-1·min-1, value of BIS<60 injection Rocuronium 0.9mg/kg, value of BIS<50 and maintain 5s went endotracheal intubation with mechanical ventilation. Intraoperative adjusted target-controlled infusion of propofol effect-site concentration, so that BIS maintained at 45±5. Muscle relaxants was then infused additional regularly to maintain muscle relaxation. Values of heart rate (HR), invasive arterial blood pressure (ABP), propofol effect-site concentration (Ce), BIS were recorded at the dexmedetomidine infusion given before (To), after given dexmedetomidine infusion (T1), before intubation (T2), after intubation (T3), the skin incision (T4), probe (T5), end of operation (T6) and extubation (T7).We recorded operation time, recovery time, propofol and remifentanil total drug, number of intraoperative adverse events and frequency of use of vasoactive drugs.Results:①Age, sex ratio, body mass index, operation time, recovery time, extubation time have no significant difference among four group (P>0.05). Intraoperative remifentanil required (41.2±12.4,39.8±17.1,37.9±13.3,45.3±10.9)μg in group C and group D1-3, no significant difference among four groups (P<0.05).②The value of effect-site concentration of propofol required for induction of group D1-3 is (2.6±0.3,2.2±0.4,1.8±0.3)μg/mL, group C is (3.0±0.4)μg/mL, difference among the four groups was statistically significant (P<0.05). The value of propofol total in intraoperative of group D1-3 is (1150±400,948±352,903±259) mg, group C is (1304±374) mg, there was significant difference between among the four groups (P<0.05).③ompared with T2, Values of SP, DP and MAP to patients of group C and group D1 were significantly increased (P<0.05) at the intubation (T3), after skin incision (T4), exploration (T5) and extubation (T7).Compared with To, values of HR were significantly lower (P<0.05), values of SP, values of DP and MAP were significantly higher (P<0.05) in group D3 at T1.④Values of BIS of intraoperative time points among four groups difference were not statistically significant (P>0.05). Compared with To, Values of BIS were significantly lower (P<0.05) in group D1-3 at T1. Compared with D3, values of BIS were significantly higher(P<0.05) in group D1-2 at T,.Conclusion:The three kinds of doses of dexmedetomidine infusion have significant sedative effects and reduce the target-controlled infusion of propofol effect-site concentration, reducing the dose of propofol. The cardiovascular in group 0.5μg/kg dexmedetomidine is more stable through intravenous infusion before induction of anesthesia...
Keywords/Search Tags:Dexmedetomidine Determined, Propofol, Target-controlled Infusion, Remifentanil, Bispectral Index
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