The Effects Of Exmedetomidine On Stress Reaction For Total Laparoscopic Hysterectomy

Objective:To observe the effects of dexmedetomidine(DEX) continuous infusion on hemodynamics and stress reaction in patient undergoing laparoscopic hysterectomyMethods:Totally60patients(ASA Ⅰ～Ⅱ)undergoing selective laparoscopic hysterectomy under general anesthesia were enrolled in this study. The patients were randomly divided into dexmedetomidine group(n=30, group D)and control group(n=30, groupP). Group D received intravenous pump injection of dexmedetomidine0.6pg/kg10min before intubation of anesthesia induction, and then received continuous injection of dexmedetomidine at a rate of0.4μg/(kg-h) until30minutes before the end of surgery. while control group not injection of dexmedetomidine. Two groups of patients have the same anesthesia induction and maintenance. The anesthesia maintaining propofol by Target Controlled Infusion, Adjust the dosage of propofol to keeping the BIS45to50. In the operation adjust the dosage of refentanyl to maintain BP fluctuation around20%of basic values. Mean arterial pressure(MAP)and heart rate(HR)were recorded at entering operation room(TO), intubation (T1), beginning of the operation (T2),10min after pneumoperitoneum(T3) and5min after de-pneumoperitoneum(T4). Tube drawing(T5).Meanwhile, the levels of Peripheral blood cortisol、adrenaline and norepinephrine at T0、T1、T3、T4、 T5in both groups were measured。Results: 1. Two groups of patients’age, BMI, operation time, etc. Comparative differences had no statistical significance。2.Compared with TO,MAP and HR in group p obviously increased at T1～5(P<0.05). MAP and HR have no obvious change in Group D.3. The level of Cortisol in P group at T1, T3, T4and T5are higher than the base value. Compared TO with T1, there is no statistical significance in Group D. There are statistically significant of diffences between the two groups.4The level of Adrenaline in P group at T1, T3, T4and T5are higher than the base value. There is no statistical significance in Group D. The level of Adrenaline in D group are significantly lower than P group at T1、T3、T4、T5Point.5.The level of norepinephrine in P group at T1, T3, T4and T5are higher than the base value. There is no statistical significance in Group D. The level of norepinephrine in D group are significantly lower than P group at T1、T3、T4、 T5Point.Conclusion:1.Intravenous pump injection of dexmedetomidine can make the Perioperative hemodynamic stability;2. Intravenous pump injection of dexmedetomidine can inhibit the release of adrenaline、norepinephrinetion and cortisol. and reduce the stress reaction of anesthesia during the operation.