The Effect Of Flumazenil On Plasma Orexin-A In Patients Under Propofol And Sufentanil Assisted General Anesthesia

Objective To explore the effect of flumazenil on plasma orexin-A in patients sedated by propofol under general anesthesia,and seek the suitable method of flumazenil administration.Methods Forty ASA I or II patients undergoing laparoscopic total hysterectomy or laparoscopic hysteromyoma decollement were divided into 2 groups randomly.Flumazenil groups(F groups,n=20)and normal saline groups(N groups,n=20).In all Patients,after general anesthesia beginning to operate,propofol given intravenously to maintain the BIS at 50~60 and infusion was ceased at the end of her procedure.When the operation was completed,flumazenil 0.007 mg/ kg i.v.was infused to the patients in group F and normal saline 0.007 ml/ kg to the group N.Changes of heart rates(HR),mean artrial pressure(MAP)and BIS of all patients were monitored at following time points: pre-dosing(t0),5min(T1),15min(T2)and 30min(T3)after administration.The time of reviving and the time of pulling out the endotracheal tube were recorded.The expression of plasma orexin-A was measured at following time points: pre-dosing(t0),5min(T1),15min(T2)and 30min(T3)after administration.Results When propofol infusion was ceased,BIS was ranged from 50 to 60 in all patients.After flumazenil administration,BIS was increased.The time of reviving and pulling out the endotracheal tube of group N was longer than group F(P<0.05).Compared with T0 orexin-A in two groups were significantly increased at T1,T2,T3(p<0.05).Compared with group N,orexin-A increased significantly in group F at 5-30 min after administration.Conclusion Flumazenil can increase the plasma orexin-A of patients under general anesthesia,reduce the time of revival.