Pulmonary protection of dexmedetomidine under general anesthesia in patients with sepsis
10.3760/cma.j.issn.0254-1416.2015.02.016
- VernacularTitle:右美托咪定对脓毒症患者全麻时肺保护作用
- Author:
Hongfang WEI
;
Yongxue CHEN
;
Fei WANG
;
Shuhe LI
;
Xinbo WANG
;
Xiaobin YANG
- Publication Type:Journal Article
- Keywords:
Dexmedetomidine;
Sepsis;
Respiratory distress syndrome,adult;
Intraoperative complications
- From:
Chinese Journal of Anesthesiology
2015;35(2):200-203
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate pulmonary protection of dexmedetomidine under general anesthesia in the patients with sepsis.Methods Fifty patients with sepsis,aged 50-64 yr,weighing 50-75 kg,of ASA physical status Ⅲ or Ⅳ,were randomly divided into 2 groups (n =25 each) using a random number table:control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with midazolam,fentanyl,propofol and cisatracurium,and maintained with infusion of remifentanil and propofol and intermittent iv boluses of cisatracurium.The patients were endotracheally intubated and mechanically ventilated.In group D,dexmedetomidine 1.0 μg/kg was infused over 10 min,followed by infusion at 0.4 μg · kg-1 · h-1 for 2 h before induction of anesthesia.While the equal volume of normal saline was given in group C.BIS value was maintained at 40-60.Immediately before skin incision,at 2 h after beginning of skin incision,and at 24 h after operation,arterial and venous blood samples were taken for blood gas analysis and for determination of the concentrations of serum procalitonin,interleukin-6 and tumor necrosis factor-alpha.Oxygenation index was calculated.Results Compared with group C,oxygenation index was significantly increased,the concentrations of serum procalitonin,tumor necrosis factor-alpha and interleukin-6 were decreased,and the rate of improvement of pulmonary function was increased in group D.Conclusion Dexmedetomidine (infusion at 0.4 pg · kg-1 · h 1 for 2 h after infusion of 1.0 μg/kg) before induction of anesthesia provides pulmonary protection under general anesthesia in the patients with sepsis.
