Comparison Of The Effects Of Diazepam And Dexmedetomidine Combined With Propofol On Cervical Conization

Objective: Conization of cervix is one of the common operations in gynecology,which is characterized by short operation time,light stimulation,and it has higher request on effect of anesthesia,onset time of anesthesia and recovery time.And it can be completed by the general sufentanil combined propofol,but the depth of intraoperative anesthesia is not eno?gh,which is usually due to the fact that body reaction affects the operation,excessively deep in anesthesia will easily present respiratory depression,recovery delay.And postoperative prone to pain response,chills,nausea and vomiting and other adverse reactions.As a new type of highly selected ?2 adrenergic receptor agonists,Dexmedetomidine(DEX,Dexmedetomidine)has an effect on sedative,analgesic,inhibition of sympathetic activity,and it is easy to wake up the patients during surgery,its biggest feature is no respiratory depression.Digoxin is a mixed receptor excitatory antagonists which is belonged to powerful opioid,Excitatory k receptors.On the ? receptor partially excited part of the role of antagonism,it can produce potent analgesic and good effect of sedative,it is difficult to produce tolerance,and less effect on respiratory depression.The objective ofthis study was to compare the efficacy target-controlled infusion of propofol combined with dexmedetomidine and diazepam for analgesic sedation and clinical feasibility and safety for cervical conization and the occurrence of adverse reactions.Methods: A total of 60 patients undergoing elective anesthesia(TIVA)underwent cervical conization were selected as the subjects.The age was between 35 and 45 years,BMI is between 18.5 and 24,ASAI-II,was randomly divided into A(control group)? B(experimental group)two groups.The two groups were respectively infused a dose of Dicetaxel 0.1mg/kg and Dexmedetomidine 0.8?g/kg(about 10 minutes)before surgery,followed by administration of sufentanil 0.1?g/kg,followed by target-controlled infusion of propofol.The process of propofol is to set the plasma target concentration at 1.2 ?g/ml.and gradually increase with 0.1?g/ml.When it is balanced to the concentration of the effector chamber for 2 minutes until the eyelash reflex disappears,the operation begins.The BIS was maintained between 50 and 60,and the target concentration of propofol was adjusted accordin g to the change of patient response and bispectral index(BIS).5 minutes before the end of surgery to stop infusion of propofol.(1)The mean arterial blood pressure(MAP),heart rate(HR)were measured and recorded in five minutes after the patients' admission(basis values)(T0),operation start(T1),operation start 10 minutes(T2),end of operation(T3)and consciousness recovery(call open eyes)(T4),pulse oximetry(Sp O2),respiratory rate(RR);(2)operation time;propofol average effect chamber concentration,propofol total dosage;wake time(stop propofol infusion to call Eyes)and the usage of adjuvant and so on.(3)spontaneous open eyes 10 min Ramsay score and Visual Analog Scale(VAS)after the operation and anesthesia satisfaction score and so on.(4)the occurrence of intraoperative and postoperative adverse events.Results: All the operations of the patients were all completed successfully,the operation time,VAS score and anesthesia satisfaction score of the two groups had no obvious differences(P>0.05).Propofol average effect chamber concentration(1.68+0.23)?total dosage(149.57+9.89)?recovery time(4.20+0.71)?Ramsay score(2.77+0.73)of Group B were all less than Group A(2.11+0.32),(168.47+8.21),(5.03+0.93)?(3.83+1.12)(P<0.05).There was significant difference in the mean arterial pressure between T1 and T2 at A group(P <0.05),There was significant difference in HR at T1 compared to T0 at B group(P <0.05),there was no statistical significance between the other time points.B group Sp O2 to maintain satisfaction,A group of 4 patients with respiratory depression,the two groups of patients after the medication were slowed down the number of breathing.In group B,the incidence of adverse reactions was less than that of group A.(P <0.05)Conclusion: Compared to dicetaxel,the effect of dexmedetomidine on cervical conization is effective and feasible,which can maintain the stability of hemodynamics,reduce the incidence of adverse reactions after the operation.But we should pay attention to its impact on heart rate.