| Objective:By Boiz.com system, the biological electrical impedance principle, the hemodynamic indexes which are closely related to SWGS-catheter have been arrived under several noninvasive conditions. Compare the hemodynamic trend given DEX and propofol and discuss their stability, at the same time evaluate the anesthesia effection and adverse reactions to provide reference for clinical application.Methods:Collecting 64 cases of the thyroid resection patients, without high b-lood pressure, coronary heart disease, diabetes and central nervous syste-m disease, each viscera function usual, not giving any preoperative medication, ASA I or II in Chengde Medical College affiliated hospital fro-m September, 2013 to August, 2014. It was divided into 2 groups(n=32) by random data table: DEX group(group D) and propofol group(g rou-p C).After entering the operating theater, the patiences were established venous pathway and given(1) and atropine sulfate injection 0.25 mg,(2) midazolam injection 0.1 mg/kg,(3) DEX 1.0 μg·kg-1 to group D within 10 min, propofol 2 mg/kg to group C,(4) fentanyl 0.05 mg/kg,(5) rocuronium hydrochloride 0.6 mg/kg to induce intubation, then by intravenous pumping, DEX 0.5 μg·kg-1·h-1 compound with remifentanil 0.25μg·kg-1·min-1to group D, propofol 4mg·kg-1·h-1 compound with remifentanil 0.25μg·kg-1·min-1 to group C. Atracurium was given to maintain muscle relaxant effect. Anesthesia depth detector(BIS) is applicated to emonitor anesthesia depth. BIS: 40~50.Record the patients’ general condition. Bioz.com system is used to monitor the digital noninvasive hemodynamics among the different point-s. Record the number of the response from cardiovascular adverse even ts and doses of the medication. Record thecompound anesthetic dosage and liquid intake. Record the points when spontaneous breathing, rection, orientation recovery and eye opened. Record the general anesthesia complications. Record the sedative, analgesic and revival scores after po-stoperative 30 min. At the same time, analyze the experimental data co mbined clinical anesthesiology by statistics.Results:1 General monitoring results1.1 For the age and sex, DEX group(group D) and propofol group(group C) have no statistical significance.(P > 0.05)1.2 For the height, weight and body mass index, group D and group C have no statistical significance.(P > 0.05)1.3 For the based blood pressure and heart rate, group D and group C have no statistical significance.(P > 0.05)2 Bioz.com monitoring results2.1 For the interclass differences contrast only, group D and group C have statistical significance on CO, SV, SVR, TFC, ACI, LCW, STR(P<0.05), i.e, during the diferent anesthesia pionts, the trends of the above indexes are also different..2.2 For the between groups differences only, group D and group C have statistical significance on LVET.(P<0.05), during the diferent anesthesia points, the trend of the LVET is also different, group D is more smoothly than group C.2.3 For the both between groups and interclass differences contrast, group D and group C have statistical significance on HR, SBP, DBP, MAP.(P<0.05), during the diferent anesthesia pionts, the trends of the HR, SBP, DBP, MAP are also different, group D is more smoothly than group C.3 The number of cardiovascular adverse events and medication doses3.1 Compared the group D with group C, for HR increased, DBP decreased and MAP decreased, the groups have statistically significance.(P<0.05)3.2 Compared the group D with group C, group D heart rate reduced need atropine treatment for 2 times, 0.5 mg, other drugs are not used.4 The intraoperative compound anesthetic dosage 、 time and input-output number recorded4.1 For the intraoperative compound anesthetic dosage, group D and group C have no statistical significance on anesthesia time, the dose of fentanyl.(P>0.05) While the difference on the refentanyl dose is statistically significant(P < 0.05), group D is less than group C.4.2 For the the input-output number record, group D and group C have no statistical significance.(P>0.05)5 The time points when spontaneous breathing, rection, orientation recoery and eye openFor the time points when spontaneous breathing, rection, group D and group C have no statistical significance.(P<0.05) For the time points when orientation recovery and eye open, the two groups have statistical significance.(P < 0.05)6 The general anesthesia complicationsDuring the general anesthesia, compared the group D with group C, group D does not appear any complications of general anesthesia while postoperative convulsions appear in 2 cases in group C.7 The sedative, analgesic and revival scores after postoperative 30 min7.1 After postoperative 30 min, group D and group C have statistical significance on the sedative scores, group D is longer than group C.(P < 0.05)7.2 After postoperative 30 min, group D and group C have statistical significance on the revival, analgesic scores.(P < 0.05)Conclusion:DEX and propofol compound anesthesia have their advantages. However by Boiz.com® system, the biological electrical impedance principle, the hemodynamic indexes which are closely related to SWGS-catheter have been arrived under several noninvasive conditions. The hemodynamic change trend of the thyroidectomy given DEX is more stable than propofol. At the same time, expand the application of a noninvasive hemodynamic monitoring.Evaluating the anesthesia effect and adverse reactions, compound anesthesia with DEX can be effective, descrease the anesthesia complications, and prolong the postoperative sedation analgesia. Above all, compound anesthesia with DEX can be used for general anesthesia. |
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