Observation Of The Effect Of Dexmedetomidine In Sedation Intubation For Severe Scoliosis Operation

Objective:To observe the change of blood pressure, heart rate, oxygen saturation and the rate of intubation success and degree of comfort of Severe scoliosis patients inducing by common dose Dexmedetomidine?Dex? during trachea cannula of severe scoliosis orthormorphia, which will help us to assess whether Dex can be used to induce sedation during trachea cannula of these patients. Methods:60 severe scoliosis outfit pelvic traction patients, ASA assessment 2-3 grade, modified Mallampati classification 3-4 grade, randomly were assigned into sevoflurane?SEV? group and DEX group according to random number table. The age, weight, ASA assessment, modified Mallampati classification were no statistically significant difference between two groups?p>0.05?. Both groups of patients were performed pars laryngea pharyngis surface anesthesia and thyrocricocentesis endotracheal anesthesia. Before induction both groups were given sufentani 0.2ug/kg.Patients of SEV group were induced by the tidal- volume method, and DEX group were induced by dexmedetomidine continuous infusion. Both groups of patients were performed nasal traches cannula guiding by fiber bronchoscope, while eyelash reflex loss and cerebral state index?CSI? fluctuating between 60-70. The mean arterial pressure?map?, heart rate?HR?, oxygen saturation?Sp O₂? of two groups patients were recorded at T₁?before induction?, T₂?eyelash reflex loss?, T₃?intubation?, T₄?three minutes after intubation?, while degree of patient comfort, once success rate of intubation and total successful intubation cases were recorded. Result:1?Baseline data of both groups were no statistically difference?p>0.05?; 2?There were no significant statistically difference of MAP, HR, Sp O₂ between Dex and Sev groups at T₁?p>0.05?; 3?MAP,patients in Dex group shouldn't be treated because the decline range of MAP was less than 20%; compared to Dex group, MAP was significantly decreased at T₂ and significantly increased at T₃ in Sev group?p<0.05?; 4?HR,HR was more than 50 at T₂ in Dex group; HR was significantly decreased at T₂ in Dex group compared to Sev group, but inverse, HR was significantly increased in Sev group compared to Dex group at T₃?p<0.05?; 5?Sp O₂,Sp O₂ was more than 95% in DEX group at T₃.There was no statistically difference at T₂?p>0.05?; however, Sp O₂ was significantly decreased at T₃ in Sev group compared to Dex group?p<0.05?; 6?Intubation times and degree of patient comfort in Dex group were little more than Sev group, and there was no statistically significant difference between the two groups?p>0.05?; however, the once success rate of intubation was significantly increased in Dex group compared to Sev group?p<0.05?; furthermore, total successful intubation rate was no statistical difference between both groups. Conclusion: 1 ? Dex administration can provide favorable sedation, oxygen saturation and stable hemodynamice status during tracheal intubation of severe scoliosis patients; 2 ? Dex administration can increase once success rate of intubation of severe scoliosis patients; 3?Dex administration is safe for severa scoliosis patient during nasal traches cannula guiding by fiber bronchoscope, and can be one of optional medicine during tracheal intubation of these patients.