Comparison Of The Sedative Effects Of Dexmedetomidine On Patients Undergoing Gynecological Laparoscopy

[Objective]:Dexmedetomidine is a highly a2adrenoceptor agonist which has antisympathesis, sedation, analgesia and hemodynamically stable effects but no respiratory depression.And is widely used in clinical. The current study was to investigate the effects of single intravenous infusion of three doses of dexmedetomidine on comparison of the effects of dexmedetomidine on patients undergoing gynecological laparoscopy with Narcotrend as the index of depth of anesthesia.[Methods]:Double-blind, randomized controlled investigating methods were employed. Eighty patients undergoing laparoscopic gynecologic surgery, ASA Ⅰ or Ⅱ, were randomly divided into four groups (n=20).Patients in the group D1, group D2, group D3and group C were respectively administered with dexmedetomidine0.5μg·kg-1,0.75μg·kg-1,1.0μg·kg-1and sodium chloride injection by micro-pump in10minutes before anesthesia induction. Four group were under same anesthesia induction and the propofol target plasma concentration was adjusted according to NI. Propofol effect-site concentration and hemodynamic changes were recorded before drug using(TO), before induction of anesthesia(T1), immediately before(T2) and after tracheal intubation(T3), before skin incision and pneumoperitoneum (T4),10min after pneumoperitoneum (T5),20min after pneumoperitoneum(T6),30min after pneumoperitoneum(T7).at the end of operation(T8) and after extubation (T9). Recovery time were recorded.[Results]:There was no difference among the four groups in anesthesia time and waking time (P>0.05). But the doses of propofol were significantly different (P<0.01), the group C, group D1group D2and group D3were (8.2±s1.2),(5.0±1.5),(4.5±+1.1)and (3.5±1.2) mg·kg-1·h-1. The propofol effect-site concentration of group D1group D2and group D3were lower than that in group C (P<0.01), and group D2were lower than group D1(P<0.05) group D3were lower than group D2(P<0.05) during induction and maintenance of anesthesia. Compared with group C, MAP and HR fluctuations caused by tracheal intubation were well controlled in group D1group D2and group D3. There were no serious adverse reactions in the four groups.[Conclusion]:The single infusion of dexmedetomidine can make a reduction in propofol effect-site concentration to reduce the dosage of propofol. But as the dose increased, the incidence of heart rate complications also increases accordingly. The single infusion of dexmedetomidine of the four doses were safe applied in anesthesia of patients undergoing gynecological laparoscopy.The ideal dose should be less than1.0μg· kg-1.