Effects of Dexmedetomidine Intratracheal Instillation on Quality of Emergence from General Anesthesia in Patients Undergoing Gynecologic Laparoscopic Operation
- VernacularTitle:右美托咪定气管内给药对妇科腹腔镜手术患者全麻苏醒期的影响
- Author:
Zhuo-Mei HUANG
1
;
Fei WANG
;
Xiao-Feng GAO
;
Wei-Ling LIANG
Author Information
1. 惠州市第一人民医院麻醉科
- Keywords:
dexmedetomidine;
administration;
inhalation;
anesthesia recovery period;
laparoscopy
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2018;39(1):113-118
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]To evaluate the effects of dexmedetomidine intratracheal instillation on quality of emergence from general anesthesia in patients undergoing gynecologic laparoscopic operation. [Methods]Ninety patients of ASA I orⅡ,aged 18~64 years old,weighed 40~80 kg,scheduled for elective gynecological 1aparoscopic surgery under general anes-thesia,expected surgery time 1-2 h,requiring endotracheal extubation after surgery,were randomly divided into 3 group (n=30 each):control group(group C),exmedetomidine administered intratracheally group(group D1)and dexmedetomi-dine administered intravenously group(group D2).At the beginning of operation,2 μg/kg of dexmedetomidine were infused intratracheal through the drug injection hole of disposable enhanced Ⅲendotracheal tube in group D1 and 0.5 μg/kg of dex-medetomidine were intravenous pumped in 10 minutes in group D2,while saline was used in group C.The patients were sent to postanesthesia care unit after extubaion. MAP and HR were recorded at the time of dexmedetomidine or saline infused (T0),and 5,10,15,30 min(T2-T4)after dexmedetomidine or saline infused,immediately after extubation(T5),and 5,10,15,30 min(T6-T9)after extubation.The time of the patients to recover spontaneous breath,eye opening,extubation and direc-tional power were recorded.The cough reflex scores and sedation-agitation scale during extubation,the visual analogue scale and Ramsay sedation scale at 30 minutes after extubation were also recorded.[Results]①Compared with T0,MAP and HR increased statistically at T5~T7in group C,MAP increased statistically at T5~T6and HR increased statistically at T5~T7in group D1 and D2(P<0.05).Compared with group C,MAP and HR at T5~T7decreased statistically in group D1 and D2(P<0.05).②The scores of cough reflex,sedation-agitation scale and visual analogue scale were significantly lower in group Dl and D2 than in group C(P<0.5).③The incidence of agitation,high blood pressure and tachycardia were significantly lower in group D1 and D2 than in group C(P<0.05).[Conclusions]Either intravenous pumping or intratracheal instillation of dex-medetomidine for patients undergoing gynecological laparoscopic surgery can effectively keep stable perioperative hemody-namics,relieve cough reflex,agitation incidence and enhance the quality of emergence from general anesthesia recovery.
