Application of Dexmedetomidine-assisted Controlled Anti-hypertension Combined with High Capacity Hemo-dilution in Spinal Surgeries
10.6039/j.issn.1001-0408.2015.23.30
- VernacularTitle:右美托咪定辅助控制性降压联合高容量血液稀释在脊柱手术中的应用
- Author:
Xinhua BAI
- Publication Type:Journal Article
- Keywords:
Dexmedetomidine;
Controlled anti-hyperten-sion;
High capacity hemodilution;
Spinal surgeries
- From:
China Pharmacy
2015;(23):3258-3260,3261
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To explore the safety,superiority and reliability of the application of dexmedetomidine-assisted con-trolled anti-hypertension combined with high capacity hemodilution in spinal surgeries. METHODS:40 patients with spinal surger-ies under general anesthesia were randomly divided into dexmedetomidine group (group D) and normal saline (group S) with 20 cases in each group. Both groups were given controlled anti-hypertension combined with high capacity hemodilution to carry out blood conservation and intraoperative wakeup experiment. Group D was given 1 μg/kg dexmedetomidine within 10 min by micro pump 10 min before anesthesia induction;maintained with 0.4-0.8 μg/(kg·h)during controlled anti-hypertension;injected with dex-medetomidine 0.2 μg/(kg·h) during wakeup experiment and anesthesia maintenance period until tracheal catheter was extracted. Group S was given normal saline instead,and the usage was same as group D. Heart rate (HR),mean arterial pressure (MAP) and central venous pressure(CVP)of patients were observed and recorded before pump injection of dexmedetomidine(T0),1 min after tracheal intubation(T1),10 min after anesthesia induction(T2),30 min after anesthesia induction(T3),wakeup(T4),at the end of controlled anti-hypertension(T5),at the end of operation(T6),during tracheal extubation(T7). Meanwhile,the wakeup ex-periment time,blood loss when wakeup,total amount of nitroglycerin,mean density of inhaled isoflurane,total amount of nitro-glycerin,total blood loss,and post-operative wakeup time of both groups were recorded. The case number of post-operative de-layed wakeup chill and dysphoria were calculated in both groups. RESULTS:Compared with at T0,HR of both groups at T1 and T7 were faster,and MAP and CVP increased,and that of group S was more significant than that of group D(P<0.05). HR and MAP of both groups at T3 were significantly lower than T0(P<0.05). Compared to group D at T4,MAP and CVP of group S at T4 were increased and HR were faster (P<0.05);the wakeup experiment time and post-operative wakeup time of group D were shorter than those of group S (P<0.05);the blood loss when awaken and total blood loss were less than group S (P<0.05);the total amount of nitroglycerin,mean density of inhaled isoflurane and total amount of remifentanil were all lower than those of group S (P<0.05);the incidence of post-operative delayed wakeup,chill and dysphoria in group D were significantly lower than those of group S (P<0.05). CONCLUSIONS:The application of dexmedetomidine-assisted controlled anti-hypertension combined with high capacity hemodilution in spinal surgeries can bring more stable and effective controlled anti-hypertension. It can also reduce the amount of nitroglycerin,remifentanil,propofol and isoflurane significantly. It is a reliable and safe drug to be applied in assist-ed controlled anti-hypertension combined with high capacity hemodilution in spinal surgeries.
