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The Influence of Different Doses of Dexmedetomidine on Hemodynamic and Effect of Propofol Given by Target-controlled Infusion

Author: ZhangJun
Tutor: CaoDeQuan
School: Central South University
Course: Anesthesiology
Keywords: Dexmedetomidine for Propofol Target-controlled infusion Remifentanil Bispectral Index
CLC: R614
Type: Master's thesis
Year: 2011
Downloads: 156
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Abstract


Objective To investigate the different fixed dose dexmedetomidine on propofol target-controlled infusion concentration and hemodynamic effects select 60 cases of anesthesia for elective abdominal surgery patients, aged 18-65 years, body mass index (BMI) 18 -25 kg/m2, ASA classification grade Ⅰ - Ⅱ, were randomly divided into a control group (C group) and observation group (D), the observation group was divided dexmedetomidine given different doses of D1 (0.25μg/kg (with saline), D2 (0.5μg/kg), D3 (1.0μg/kg) group, 15 cases each, respectively, before the induction of anesthesia, 10min intravenous infusion of 10 m1 saline and different doses of dexmedetomidine given was diluted to 10ml). After the end of the infusion, the induction of anesthesia with target-controlled pump (Grasby) infusion of propofol, the initial effect-site concentration of propofol is set to 1.5μg/mL every 1min BIS increase 0.3μg/mL remifentanil 0.2μg · kg-1 · min-1 infusion, BIS lt; 60 bolus rocuronium 0.9mg/kg, the BIS value ≤ 50 underwent mechanical ventilation to maintain 5s tracheal intubation. Regulation of phenol target-controlled infusion of propofol Ce intraoperative BIS maintained at 45 ± 5; timing additional muscle relaxants maintain the muscle relaxant. Profiler records infusion of dexmedetomidine fixed former (T0) the infusion right beauty care Mi given after (T1), before intubation (T2), endotracheal intubation (T3), skin incision (T4) (T5), of operation (T6) and extubation (T7) at each time point heart rate (HR), invasive arterial blood pressure (ABP), the effect-site concentration of propofol (Ce), BIS values; recorded surgical time, recovery time, C the total amount of propofol and remifentanil medication,; adverse reactions were recorded occurrences of the number and use of vasoactive drugs. Results (1) four groups of patients age, sex ratio, no significant difference in body mass index, surgical time, recovery time, time to extubation group difference was not statistically significance (P gt; 0.05); in group C, D1-3 group remifentanil too Nepal medication GDP were 41.2 ± 12.4μg, 39.8 ± 17.1μg, 37.9 ± 13.3μg, 45.3 ± 10.9μg, the differences between the two groups was not statistically significant (P lt; 0.05). ② induction required propofol Ce values ??in group C (3.0 ± 0.4) μg / mL, D1-3 group (2.6 ± 0.3,2.2 ± 0.4,1.8 ± 0.3) μg / mL, the difference between the groups was statistically significance (P lt; 0.05); propofol medication total C group (1304 ± 374) mg, and D1-3 group (1150 ± 400,948 ± 352,903 ± 259) mg, the difference between the two groups statistically significant (P lt; 0.05). ③ group comparison, C, D1 patients SP, DP, HR intubation (T3), skin incision (T4), the Profiler (T5), extubation (T7) before the time of intubation (T2), compared to the average significantly higher (P lt; 0.051); D3 group of patients with T1 compared with T0, HR was significantly lower (P lt; 0.05), SP, DP was significantly increased (P lt; 0.05); ④ group comparison, D1-3 group BIS values ??T1 compared with T0 lower, the difference was statistically significant (P lt; 0.05) between the two groups D3 and D1, D2 the difference was statistically significant (P lt; 0.05). Conclusions 0.25μg/kg 0.5μg/kg 1.0μg/kg 3 dose dextromethorphan prop microphone orders infusion can produce significant sedative effect, lowering the target-controlled infusion of propofol effect-site concentration, reduce the dose of propofol dose increase, the enhanced role. Which intravenous infusion before right medetomidine 0.5μg/kg-induced cardiovascular responses are more stable.

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CLC: > Medicine, health > Surgery > Surgical operation > Anesthesiology
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