The Effect Of Dexmedetomidine Hydrochloride To The Stability Of Patients Undergoing Radical Mastectomy During Epidural Anesthesia

Dexmedetomidine is a new type of high selective α2-adrenergic receptoragonists, which has sedative, analgesic and anxiolytic effects, has no respire-atory depression. Because of its distinctive clinical effect,it has been usedwildly in clinical medicine, especially as an adjuvant in anesthesia, providingthe anesthesiologist a new choice. However, there is little research about givingthe dexmedetomidine to patients undergoing radical mastectomy duringepidural anesthesia.Objective: Evaluate the effects of sedative, analgesic and forgotten, whendexmedetomidine was applicated to patients undergoing radical mastectomyduring epidural anesthesia.Methods: Select40patients who were undergoing radical mastectomyduring epidural anesthesia as the research object. All the patients wereASAⅠ-Ⅱ, aged35-65years, weight45-80kg. Patients were randomly dividedinto two groups, the experimental group（dexmedetomidine group) and controlgroup (saline group). Each group has20patients. After routine monitoringevery patient received epidural anesthesia with0.5%ropivacaine. The patientsof the experimental group before surgery10min were given dexmedetomidineloading dose of0.7μg/kg, the infusion time is10min, followed by0.5μg/（kg*h） for maintenance; control group received an equal volume ofphysiological salt.Recording the heart rate (HR), systolic blood pressure (SBP),diastolic blood pressure (DBP), main arterial blood pressure(MAP) andRamsay score of patients in each group at the moment when patient came in theoperation room,the moment started to infusing dexmedetomidine (T0),5minute after infusing dexmedetomidine (T1),10minute after infusingdexmedetomidine (T2),15minute after infusing dexmedetomidine (T3),20minute after infusing dexmedetomidine (T4),30minute after infusingdexmedetomidine (T5),40minute after infusing dexmedetomidine (T6),50minute after infusing dexmedetomidine (T7),60minute after infusingdexmedetomidine (T8),at the same time, recording the degree of surgicalforgotten and postoperative adverse. Use SPSS19.0statistical software forstatistical processing.Results:1. The difference between experimental group and control group in age,gender, weight and intraoperative fluid volume was not statistically significant.The two group had comparability.2. Ramsay score was not significantly different between two groups at T0and T1, ramsay score was significantly different between two groups at T2～T8.Furthermore, Ramsay score in experimental group was significantly higher thancontrol group.3.There were significantly less patient went through referred pain inexperimental group than control group.4. HR, SBP, DBP and MAP were not significantly different between twogroups at T1.SBP, DBP and MAP were in experimental group was significantlyhigher than control group at T2.SBP, DBP and MAP were in experimentalgroup was significantly lower than control group at T3～T8.Furthermore, HRin experimental group was significantly lower than control group at T2～T8.5. The degree of postoperative forgotten was significantly differentbetween two groups, and the rate of completely forgotten in experimental group(70%) was statistically higher than control group (0%).6. The number of cases of nausea, vomiting, respiratory depression,bradycardia, restlessness and drowsiness were not significantly different betw- een experimental group and control group.Conclusion:1. The application of dexmedetomidine in patients undergoing radicalmastectomy during epidural anesthesia could provide comfortable calm forpatients,increase tolerability to pain, eliminate poor memory appearing bec-ause of surgery,but not increased the impact of hemodynamic changes which iscaused by epidural anesthesia2. The application of dexmedetomidine in patients undergoing radicalmastectomy during epidural anesthesia. will not produce nausea, vomiting,respiratory inhibition, bradycardia, restlessness and drowsiness.