| Objective: Coronarography is the golden standard diagnostic of coronary heart disease (CHD) and also is the golden standard severity evaluation of the coronary artery. Conventional coronary angiography is carried out under local anesthesia. On account of the patient fully awake, the patient may be in the excessive stress. The mental representation of fear, anxiety and stress will manifest as the increasing of heart rate, strengthen of the myocardial contractility and a rise on blood pressure. Thereby it can increase the oxygen consumption of the myocardium, aggravation of the myocardial ischemia. All these factors may lead to serious complications. We can use some sedative and analgesic drugs to make patients feel more comfortable.Methods: 60 Patients which are scheduled for the coronary angiography are divided into three groups(A: DEX dexmedetomidine), (B: midazolam),(C: matched group).There are 20 patients in each group.The group A is injected with dexmedetomidine at the rate of 1μg/kg, uniform infusion of 15 minutes. After having finished the loading, we give the group continuous infusion with 0.1-0.7μg/kg/h.Patients of group B are given intravenous injection of midazolam 30-40μg / kg; Patients of group C are given saline 5ml by intravenous.We observed the systolic blood pressure before treatment, after treatment 5 min, before angiography, when the catheter under local anesthesia, contrast 2 h after the end. And we observed diastolic blood pressure, heart rate, oxygen saturation, and record the level of sedation separately like the same. And we record the untoward reaction: low heart rate(heart rate<50/min), tachycardia(heart rate>100/min),low blood pressure(diastolic pressure <85 mmHg),high blood pressure(diastolic pressure >170 mmHg),respiratory depress (breath rate<8/min), anaphylactic response ,nausea and vomiting . Results: The three groups of patients age, weight, height, gender differences were not statistically significant, the three groups at any time of SPO2 and respiratory rate were not significantly different, P> 0.05. SPO2 all patients were> 95% of all patients in the process of respiratory depression score of 1-3 points.Compared with group C, the mean arterial pressure is lower after the administration 5min, before angiography and local anesthesia. the difference was significant (P <0.05);compared with group B, the Council Ma when the mean arterial pressure is lower, the difference was significant (P <0.05).Sedation score: Compared with group C, there was a significant difference, (P <0.01);There are no significant difference between group A and group B. (P> 0.05).Co-operation in the ratings for: Compared with group C, there was a significant difference, (P <0.01);There are no significant difference between group A and group B. (P> 0.05).Postoperative analgesia for surgery, sedation satisfaction scores, A group, B group compared with the C group, the difference was statistically significant (P <0.05), A group and B group, the difference was not statistically significant ( P> 0.05).Forgotten level, A group, B group and C group compared to the difference was statistically significant (P <0.05), A group and B group, the difference was statistically significant (P <0.05)The incidence of adverse reactions, those with hypertension: The difference between group A and group B was significant, (P <0.01); Combined with concurrent tachycardia: the difference was also significant, (P <0.01). In bradycardia, hypotension, respiratory depression, nausea, vomiting, allergic reactions, no significant difference in those aspects.Conclusion: Compared with midazolam, Dexmedetomidine can make the blood dynamics more stable, less incidence of side effects when in coronary angiography under local anesthesia in surgery. |
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