Original Article
Effects of different doses of dexmedetomidine combined with propofol and remifentanil target controlled infusion on postanesthesia recovery of patients in functional endoscopic sinuses surgery
Lei Ma, Jing Xu, Shanglong Yao, Zhongjun Zhang, Xueping Zhang, Zhongliang Dai
Published 2016-04-05
Cite as Chin J Postgrad Med, 2016, 39(4): 366-370. DOI: 10.3760/cma.j.issn.1673-4904.2016.04.022
Abstract
ObjectiveTo investigate the effects of different doses of dexmedetomidine combined with propofol and remifentanil target controlled infusion (TCI) on postanesthesia recovery of patients in functional endoscopic sinus surgery.
MethodsEighty ASA Ⅰ or Ⅱ grade patients, scheduled for the endoscopic sinus surgery, were divided into control group (20 cases) and dexmedetomidine group (60 cases) according to the random digits table method. The patients in dexmedetomidine group were given loading dose dexmedetomidine 0.6 µg/kg, then were given dexmedetomidine of different maintenance doses: 0.3 µg/(kg·h) in D1 group, 0.6 µg/(kg·h) in D2 group and 0.9 µg/(kg·h) in D3 group. The patients in dexmedetomidine group were given TCI propofol and remifentanil during the maintenance of general anesthesia, rocuronium was administrated intermittently during operation, and bispectral index (BIS) was controlled at 40 -50. The changes of hemodynamics 5 -10 min after entering operation room (T0), before induction (T1), 1 min after intubation (T2), 5 min after intubation (T3), before extubation (T4) and 5 min after extubation (T5) were observed. The spontaneous breathing recovery time, call of eye-opening time, extubation time and adverse reaction after surgery were recorded. Moreover, the visual analogue score (VAS) and Ramsay sedation score were used to evaluate the comfort level of patients.
ResultsThe mean arterial pressure (MAP) at T5 in control group and D1 group were significantly higher that in D2 group and D3 group, and there were statistical differences (P <0.05). The heart rate at T1 -T5 in D1 -D3 group were significantly lower than that in control group, and there were statistical differences (P <0.05). The spontaneous breathing recovery time, call of eye-opening time, extubation time in D1 -D3 group were longer than those in control group, but there were no significant differences (P >0.05). The VAS 15 min after extubation in D1 -D3 group were significantly lower than that in control group: (3.7 ± 0.3), (3.1 ± 0.4) and (3.0 ± 0.5) scores vs. (6.2 ± 0.6) scores, and there were statistical differences (P<0.05). The Ramsay sedation scores in D1 -D3 group were significantly higher than that in control group: (2.5 ± 0.2), (2.7 ±0.2) and (5.3 ± 0.3) scores vs. (1.4 ± 0.3) scores. Moreover, Ramsay sedation score in D3 group was significantly higher than that in D1 group and D2 group, and Ramsay sedation score in D2 group was significantly higher than that in D1 group. There were statistical differences (P <0.05). Four and 2 patients occurred nausea vomiting respectively in control group and D1 group within 24 h after operation.
ConclusionsDexmedetomidine combined with propofol and remifentanil TCI can maintain hemodynamic stability and improve anesthesia recovery quality.
Key words:
Anesthesia, intravenous; Paranasal sinus diseases; Dexmedetomidine; Functional endoscopic sinus surgery
Contributor Information
Lei Ma
Jing Xu
Shanglong Yao
Zhongjun Zhang
Xueping Zhang
Zhongliang Dai
Department of Anesthesiology, Shenzhen People's Hospital, Shenzhen 518020, China