A Clinical Study In Sedative Level With AAI In Eldly Patients During Induction

A Clinical Study in Sedative Level with AAI in ELdly Patients During InductionObject:In the absence of operation stimulation, AAI monitoring in elderly patients with dexmedetomidine combined with midazolam and propofol target-controlled infusion during induction of general anesthesia, sedation level of AAI in elderly patients with value and accuracy, provide relevant evidence for elderly patients’ safety, effectiveness and individual induction.Methods:40elective operation cases of60-75years old patients, operation types are not limited, according to the random number table respectively enter the dexmedetomidine (D) group and control (N) group,20cases in each group. After group D with dexmedetomidine3μg·kg-1·h-1continuing infusion20min, follows the continuous infusion of0.3μg·kg-1·h-1, group N infusion saline at the same rate. Two groups of patients in the infusion of midazolam after15minutes to75μg·kg-1, every20s to observer’s assessment of alertness/sedation (OAA/S score).Infusion of propofol after5min, the initial effect-site concentration is0.5μg·ml-1, increasing the concentration of0.5μg·ml-1,each target controlled infusion time of concentration of5min, to OAA/S score is0after5min, the end of the experiment. Records of the OAA/S score is4,3,2,1,0points when propofol effect-site concentration, HR, SpO2, MAP, AAI, intravenous injection of midazolam from start to OAA/S score of0when the total amount of propofol. OAA/S score=2, defined as the loss of verbal contact (LVC); OAA/S score≤1, defined as loss of consciousness (LOC). Record the target controlled infusion system predicted effect-site concentration (Ce) values, when changing of0.1μg·ml-1, and calculate the LVC and LOC AAI50, and provide guidance for the induction of general anesthesia in elderly patients.Results:After dexmedetomidine, the pstients’ consciousness loses, the required time gradually shortens, the dosage of propofol reduces37%, target controlled propofol effect-site concentrations decrease. MAP of group N is volatility. Two groups of patients with increasing degree of sedation, OAA/S score was lower, AAI value decreased, the difference was statistically significant. There is a good correlation between the AAI and OAA/S score in group D R2=0.72in group N R2=0.876. LVC, D33.50for group AAI50, group N was43.50AAI50, LOC, D29.00for group AAI50, group N was34.00AAI50,provide guidance for the induction of general anesthesia in elderly patients.Conclusion:1.Dexmedetomidine has clear synergistic sedation in elderly patients with midazolam combined with propofol TCI induction period, reduces the dosage of propofol at the same time, and stabilizes hemodynamics.2.AAI can monitor precisely and dynamicly the composite induction period of elderly patients with the sedation level for elderly patients with general anesthesia, dexmedetomidine combined induction has certain clinical significance, and is benefit to improve the safety of the induction of general anesthesia in elderly patients.