The Evaluation Of Dexmedetomidin In General Anesthesia Undergoing Gastrectomy With Remifentanil And Propofol In Dosage And Effect

Objective Gastric cancer is one of common malignant tumors in China, its in-cidence in our country ranks first in all kinds of tumors. Radical surgery refers to a potentially curative operation which the primary tumor along with the metastatic lymph node and infiltrating organization are all cut off and there is no residual tumor.Toinvestigate the effect of hemodynamics, the amount of anesthetic, sedation and analgesia perioperative administered dexmedetomidine in gastrectomy in general anesthesia.Methods Forty patients （ASA Ⅰ^Ⅱ） scheduled for elective gastrectomy under generalanesthesia were enrolled in this study. All patients were randomly divided into twogroups: dexmedetomidine group （group D） and control group （group C）. In D group,0.6μg/kg of the loading dose dexmedetomidine was administered intravenously bymicro-pump for within15minutes before induction of anesthesia, then0.4μg/kg·h wasmaintained until the40th min end of surgery. While in group C, the same volume ofnormal saline was given by the same way. The parameters of BIS, MAP and HR wererecored before dexmedetomidine or normal saline infused intravenously （T₁）, before theinduction of anesthesia （T₂）, immediately after intubation （T₃）,1min after intubation（T₄）, immediately after skin incision （T₅）, immediately after operation exploration （T₆）,immediately after extubation （T₇）.Anesthesia and operation durations time of eye open,extubation.response to eommandsand orientation，The administration of vasoactive drugduring operation were recorded. Analyze the total transfusion volume in the operationand urine volume after surgery. By following the respiratory depression after the surgeryand level of consciousness in the operation. The parameters were recorded such as theamount of propofol and remifentanil,Ramsay and VAS score withine four hours after operation.Results Compared to those at T₁and group C, BIS scale of group D at T₂showedsignificant decrease （P <0.01）. MAP, HR in group C had a significant increase thanthose in the group D at T₂,T₄～7（P＜0.05or P<0.01）. Propofol and remifentanilconsumption in group D were less than in group C （P <0.05）. There was nosignificant difference in the recovrer time and eye opening withtrachel extubation time from anesthesia between the two groups.1h and4h after operation, the Ramsay score in group D was significantly higher than group C,the VAS score in group D was significantly lower in group C （P <0.05）.Conclusions The application of dexmedetomidine in general anesthesia can producesignificant sedation, improve the effect of analgesia, reduce the amount of anestheticand reduce postoperative discomfort. and anesthetics consumption withoutextended recovery time from anesthesia.