The Application Of Dexmedetomidine In Gynecological Cancer Patients Given General Anesthesia In Abdominal Surgery

Objective:To explore the function of dexmedetomidine used in gynecological cancer patients given general anesthesia in abdominal surgery, and to provide reference for choosing clinical drugs.Methods:In this study,we selected gynecological 60 cancer patients who given general anesthesia in abdominal surgery at the Second Affiliated Hospital of Jilin University and Tumor Hospital of Jilin Province in January 2010 to November 2010. 36 patients are cervical cancer patients, 24 cases are endometrial cancer patients. ASA grade wasⅠtoⅡgrade. Aged 35 to 70 years old, and physiological state was well to accept general anesthesia. 60 patients were into three groups, namely group D₁ (dexmedetomidine group1), group D₂ (dexmedetomidine group 2) and group C (control group), 20 cases each. The patients in group D₁ was given 0.5μg/(kg·h) dexmedetomidine by continuous intravenous injection of 10 minutes, then 0.3μg/(kg·h). Group D₂ was given 1.0μg/(kg·h) dexmedetomidine by continuous intravenous injection of 10 minutes, then 0.6μg/(kg·h). Group C given 0.9% intravenous saline with the same method. Record the blood pressure, heart rate, inhalation of sevoflurane MAC during surgery, the end of surgery to extubation time in patients, recovery room stay time and postoperative differences in adverse reactions and other indicators. Excel and SPSS13.0 software was used for Statistical description and statistical analysis.Results:1. Among group D₁, group D₂ andgroup C, the BP was significant difference at the beginning of surgery, the end of surgery and extubation. Compared with group C, group D₁ and group D₂s'BP was significant difference at the beginning of surgery, the end of surgery and extubation(P<0.05). But there was no difference between group D₁ and group D₂(P>0.05). Compared with group C, group D₁ and D₂ at the beginning of surgery patients, the end of surgery and extubation, blood pressure was significantly reduced .2. Among group D₁, group D₂ andgroup C, the HR was significant difference at the beginning of surgery, the end of surgery. Compared with group C, group D₁ and group D₂s'HR was significant difference at the beginning of surgery, the end of surgery(P<0.05). But there was no difference between group D₁ and group D₂(P>0.05). Compared with group C, group D₁ and D₂ at the beginning of surgery patients, the end of surgery, heart rate was significantly reduced .3. Among group D₁, group D₂ andgroup C, the MAC was significant difference at the beginning of surgery, the end of surgery. Compared with group C, group D₁ and group D₂s'MAC was significant difference at the beginning of surgery, the end of surgery(P<0.05),also between group D₁ and group D₂. Compared with group C, group D₁ and D₂ at the beginning of surgery patients, the end of surgery, MAC was significantly reduced, and it was more clear in groupD₂ .4. Between group D₁, D₂ and C, the end of surgery to extubation time was no significant difference (P>0.05), while recovery room stay between the three groups were significant differences statistically significant (P<0.05), in which the recovery room group D₂ people stay longer than the group C and D₁, the difference was statistically significant (P<0.05).5. Three groups of postoperative nausea, vomiting, and agitation rate of adverse reactions were significant differences statistically significant (P<0.05), compared with D₁ and D₂ groups, more patients in group C after surgery will be nausea, vomiting and restlessness of adverse reactions. After surgery, none of three groups'patients had respiratory suppression; group D₂ only had one case of bradycardia.Conclusion:1. Gynecological cancer patients with surgery using dexmedetomidine can significantly reduced the blood pressure levels at the start, the end of surgery and extubation; also can effectively suppress heart rate caused by response to the stress. It suggests that dexmedetomidine is able to make sure the stability during perioperative.2. Dexmedetomidine has the analgesic effect, can reduce the inhaled anesthetics MAC of gynecological cancer patients, and this effect may have some dose-response relationship.3. Low-dose dexmedetomidine will not prolong the residence time in the recovery room of gynecological cancer patients.4. The incidence of adverse reactions after survey among gynecological cancer patients was significantly reduced by dexmedetomidine.