Feasibility Of Unconscious Tracheal Extubation In Patients Undergoing Thoracotomy Aided By Dexmedetomidine And Narcotrend Monitor

Objective:Explore a scheme for safe unconscious extubation with low stress response in patients undergoing thoracotomyMethods:60patients (18～65years old, ASAⅠ～Ⅱ) undergoing elective thoracotomy were randomly divided into two groups:Group C (unconscious extubation group) and Group D (unconscious extubation+dexmedetomidine group). Anesthesia induction and maintenance were all the same in both groups. Patients in group D received dexmedetomidine0.2μg/kg i.v. in10minutes1hour before the end of the surgery. Patients in group C received saline placebo of the same volume at the same time. Unconscious Tracheal extubation were performed in both groups at Narcotrend index up to80. Patient’s heart rate, blood pressure, SpO2were monitored continually. Also Narcotrend index during anesthesia recovery period, breathing recovery time, extubation time, recovery time, stay in PACU are recorded. Postoperatively, tracheal tubule tolerance, emergence agitation,■Ramsay sedation score,and untoward effects were also assessed Results:No significant difference in the base situation were noted between two groups. Breathing recovery time, extubation time in group D were markedly decreased and with superior tolerance to tracheal tubule compared with group C (P<0.05). Also group D had more stable hemodynamics and lower incidence of emergence agitation. Moreover, visual analog scale and PCA consumption during anesthesia recovery period in group D were markedly decreased compared with group C (P<0.05).Conclusion:low-stress-response unconscious tracheal extubation in patients undergoning throractomy was feasible, if aided by Dexmedetomidine and Narcotrend monitor. And it may harvest an additional benefit of lower PCA consumptions.