Clinical Research Of Dexmedetomidine Effects On Emergence Agitation After Etomidate Target Controlled Infusion General Anesthesia

Objective Discussing the right holder microphones set of etomidate emulsion under the target control infusion to maintain general anesthesia after awakening period caused by the therapeutic effect of agitation, evaluate its awakening period the influence of agitation in patients with general anesthesia.Methods A total of 100 cases (male 57,female 43,range:60-78 years, BMI: 18.5-25kg/m2,ASAI-II class) undergoing elective general anesthesia maintaining by etomidate given by TCI(target controlled infusion).All cases were randomly devided into dexmedetomidine group(n=50, Group D) and normal saline group(n=50, Group C). Two groups of patients stop to input all the anesthetic before 10 min at the end of the surgery. The patients of group C were pumped into the same volume of physiological saline with push intravenous injection pump and right set beauty holds the mi 0.5 mu g/kg (group D jiangsu hengrui pharmaceutical co., LTD., batch number:13022334), maintaining for 10 min. Anesthesia induction dose:2 mg midazolam, sufentanil mu 0.5 g/kg, cis benzene sulfonic acid atracurium 0.15mg/kg, etomidate emulsion (20 mg/en in xuzhou, jiangsu pharmaceutical 10 ml) of 0.3 mg/kg,5 minutes after tracheal intubation, mechanical ventilation immediately. Intraoperative anesthetic maintain:concentration is 0.5 ug/ml target control effect of etomidate 0 chamber (Arden Model), the concentration of 0.20 to 0.20 mu g/(kg, min), fentanyl (hubei yichang f pharmaceutical co., LTD.) Patients were given note cis benzene sulfonic acid continuously to maintain muscle relaxant atracurium. Intraoperative respiratory parameters were applied according to the blood gas analysis, respiratory co2 partial pressure maintained 35-45 mmHg at the end. To connect intravenous analgesia pump before 15 min of sewing leather (pine 0.24 mg gamla SiQiong 9 mg with physiological saline to 100 ml,2 ml/h), intraoperative maintain hemodynamic stability, maintain the bis values in 40 to 60. Two groups of patients before sewing leather 10 min stop pumping maintain anesthesia drugs at the same time, and separately in vein pump pump into the physiological saline group (C) and right beauty holds the mi 0.5 mu g/kg (D group, jiangsu hengrui pharmaceutical co., LTD., batch number:13022334) for 10 min. Round tube drawing:all patients were put into anesthesia recovery room after the operation (post-anesthetic care unit, PACU), and continue to monitor the SpO2, SBP, DBP, HR and RR. To extubate if satisfying with extubation indications. Extubation indications are:(1) the patient conscious, according to the instructions open; (2) the breathing air 5 min, SpO2> 95%; (3) spontaneous breathing smooth, RR> 10 times/min, tidal volume> 8 ml/kg; (4) to restore cough and swallowing reflex. After removal of the endotracheal tube conventional oxygen masks, recorded systolic pressure, diastolic blood pressure, heart rate value, ramsay sedation scores, including before anesthesia induction (TO), push on the right the mi or saline (T1), tube drawing immediately before the immediate (T2), when the tube drawing (T3) and 1 min after extubation (T4),5 min (T5),10 min (T6), besides agitation score during extubation.This experiment uses SPSS 13.0 statistical software for data analysis, with mean±tandard deviation (x±s) measurement data, using t test for comparison between groups, P< 0.05 was statistically significant, adopted the repeated measures design analysis of variance comparing group, P< 0.05 was considered statistically significant.Results There was no significant difference between Group C and Group D in general information and operation situation(P>0.05).to compare with TO in sedation and agitation, Ramsay sedation score in group C was lower at T2,T4,T5 (P<0.05), while in group D was significantly higher at T2,T4-6 than Group C(P<0.0l. Agitation score in group D were significantly lower than Group C, respectively (1.55+0.70):(1.29±0.81), (P=0.0025) Comparison of hemodynamics of HR, SBP, DBP in group D were significantly lower than in group C at T2-T6 (P<0.01)Conclusions Given intravenous infusion of dexmedetomidine 0.5?g/kg before the end of surgery can reduce etomidate intravenous anesthesia recovery period of restlessness, and maintin hemodynamic stability, and will not extend the time to extubation.