Effects of dexmedetomidine on hemodynamics and anesthetic dosage during general anesthesia with propofol combined with remifentanil

China Modern Medicine(2015)

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摘要
Objective To observe the effects of dexmedetomidine on hemodynamics and anesthetic dosage during general anesthesia with propofol combined with remifentanil. Methods Sixty patients underwent gynecological laparoscopic surgery in general anesthesia were selected and randomly divided into 3 groups:control group(Group P,normal saline),single infusion of dexmedetomidine group(Group D,intravenous dexmedetomidine 0.5 μg/kg)and continuous infusion of dexemdetomidine group[Group C,intravenous dexmedetomidine 0.5 μg/kg and then constant infusion at 0.15 μg/(kg·h)].SBP,DBP and HR were recorded in the following times:before injection(T0),before anesthetic induction(T1),before intubation(T2),instant after intubation(T3),after intubation of 3 min(T4),after pneumoperitoneum(T5),drug withdrawal immediately after surgery(T6),instant after extubation(T7)and after extubationof 3 min(T8).The dosage of propofol and remifentanil were recorded during the surgery. Results SBP at T3,T5 and T7,DBP at T5 and T7,HR at T1-T7 in group C was lower than that in group P respectively,with statistical difference(P0.05).SBP at T3,T5,HR at T1-T7 in group D was lower than that in group P respectively,with statistical difference(P0.05).In group P,SBP at T3,T5 and T7,DBP at T7 was higher than that T0 respectively,HR at T2,T4-T6 was lower than that T0 respectively,HR at T7 was higher than that T0,with statistical difference(P0.05).In group C,HR at T1-T6 was lower than that T0 respectively,with statistical difference(P0.05).The dosage of remifentanil in group C was less than that in goup P,with statistical difference(P0.01).The dosage of propofol in three groups was compared,with no statistical difference(P0.05). Conclusion Continuous infusion of dexemdetomidine with low dose can effectively reduce the hemodynamic fluctuation in endotracheal intubation,pneumoperitoneum and extubation from patients during general anesthesia in laparoscopic operation,as well as decrease the dosage of remifentanil.
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