The Application Of Dexmedetomidine Hydrochloride In Thoracic Aortic Aneurysms Interventional Surgery

Objective:In thoracic aortic aneurysms interventional surgery, the patientis fully conscious. When the injection point doesn’t haveexactanalgesia, the patient may have high tension, anxiety and evenfears, which clinical manifestations can be the ascend of heart rateand blood pressure, increased myocardial oxygen consumption,which lead to a disorder of myocardial cells’ oxygen supply anddemand. The disorder may cause angina pectoris, andeven seriouscomplications such as myocardial infarction (MI).Methods:60patients with abdominal aortic aneurysm undergoinginterventionoperation were selected. They were randomized into three groups usingdouble blind method,(A: DEX group, B:Midazolam group, C:controlled group),20cases of patients in each group. Patients in groupA were injected a load dose of1μ g/kg, in a consist speed within15minutes, then with0.1to0.7mu g/kg/h dose to maintain the injection.Patients in Group B were given amidazolam injection of30-40μg/kg. Patients in group C were givensaline5ml. Patients’ blood pressure,heart rate, blood oxygen saturation, as well as the degree of sedation,forgotten, postoperative psychological condition were recorded duringentering the operating room(OR),5min after entering the OR,anesthesia conducted, surgery, and after surgery. Adverse reactionswere recorded in the entire operation process.Results:The patients’ age, weight, height, gender in3groups havenodifferences. SPO2and breathing rates of each group have nosignificant differences of at any moment (P>0.05). Patients SPO2were>95%of all time. The respiratory depression score of all patients inthe whole process remain1to3points.Compared with patients in group C, Group A and groupBpatients’ mean arterial pressure were lower5min after intravenouslyinjecting the drug, conducting anesthesia and during surgery, withsignificant difference (P <0.05). Compared with patients in GroupB,Group A patients’ mean arterial pressure were much lower duringconducting anesthesia, with significant difference (P <0.05).Sedation score:Group A and Group B compared with Group C has a verysignificant difference,(P <0.01). There was no significant differencebetween Group A and Group B.(P>0.05) Intraoperative cooperation degree grade: patients in Group Aand Group B has a very significant difference compared withpatientsin Group C,(P <0.01). There was no significant differencebetweenGroup A and Group B.(P>0.05)Satisfaction of intraoperative analgesia and sedation: patients inGroup A and Group B has a very significant differencecomparedwith patients in Group C,(P <0.05). There was no significantdifference between Group A and Group B.(P>0.05)Degree of forgetfulness:patients in Group A and Group B has avery significant difference compared with patients in Group C,(P <0.05). There was no significant difference between Group Aand GroupB.(P>0.05)The occurrence of adverse reactions in different situations:patientssuffered hypertension in Group A and Group B has a very significantdifference compared with patients in Group C,(P <0.01); patientswith tachycardia in Group A and Group B has a very significantdifference compared with patients in Group C,(P <0.01). There wereno significant difference in patients withbradycardia, hypotension,respiratory depression, nausea and vomiting and allergic reaction.Conclusion:Dexmedetomidine Hydrochloride can patients’hemodynamicsmore stable during thoracic aortic aneurysms interventional surgeryusing local anesthesia with less incidence ofadverse reactions, compared with midazolam.