右美托咪啶与咪达唑仑复合舒芬太尼用于肝癌微波治疗术患者麻醉效果的比较

Objective To compare the anesthetic efficacy of dexmedetomidine and midazolam combined with sufentanil in patients undergoing microwave coagulation therapy for liver cancer.Methods Forty ASA Ⅱ male patients (aged 35-62 years and weighing 45-70 kg) scheduled for percutaneous microwave coagulation therapy were randomly divided into two groups (n =20 each):midazolam group (group Ⅰ) and dexmedetomidine group (group Ⅱ).A loading dose of midazolam 40 μg/kg (in normal saline 20 ml) was given intravenously over 10 minutes,followed by midazolam infusion at 40 μg·kg-1 · h-1 in group Ⅰ.And a loading dose of dexmedetomidine 1 μg/kg (in normal saline 20 ml) was given intravenously over 10 minutes,followed by dexmedetomidine at 0.5 μg· kg-1 · h-1 in group Ⅱ.At 5 minutes after administration of the loading dose of midazolam or dexmedetomidine,a loading dose of sufentanil 0.2 μg/kg was given,and then patient-controlled intravenous anesthesia (PCIA) with sufentanil (with the background infusion of 0.1 μg·kg-1 · h-1,bolus dose of 0.1 μg/kg and lockout interval of 3 minutes) was used.The operation was started 2 minutes after administration of the loading dose of sufentanil.The incidences of bradycardia,tachycardia,hypotension,hypertension and respiratory depression were recorded.The total attempts and effective pressing times of PCIA were also recorded.Results There was no significant difference in the incidences of bradycardia,tachycardia,hypotension,and hypertension between the two groups (P ＞ 0.05).The incidence of respiratory depression was significantly lower,and the total attempts and effective pressing times were smaller in group Ⅱ than in group Ⅰ (P ＜ 0.05).Conclusion The anesthetic efficacy of dexmedetomidine and sufentanil is better than that of midazolam and sufentanil in patients undergoing microwave coagulation therapy for liver cancer.

不同剂量右美托咪啶对单肺通气患者围术期炎性反应的影响

Objective To investigate the effects of different doses of dexmedetomidine on perioperative inflammatory responses in patients undergoing one-lung ventilation (OLV).Methods Thirty-six ASA T or Ⅱ patients (aged 43-72 years and weighing 50-78 kg) scheduled for esophagectomy were randomly divided into three groups (n =12 each):control group (group C),low dose dexmedetomidine group (group D1) and high dose dexmedetomidine group (group D2).Dexmedetomidine 1 μg/kg was infused intravenously 10 minutes before anesthesia induction,then infused at a rate of 0.2 μg· kg-1 · h-1 (group D1) or 0.5 μg· kg-1· h-1 (group D2) until 30 minutes before the end of operation.Group C received the equal volume of normal saline.Blood samples were collected before anesthesia induction (T0),immediately before OLV (T1),30 minutes after OLV (T2),90 minutes after OLV (T3),30 minutes after lung inflation (T4) and 2 hours after operation (T5) for monitoring serumlevels of tumor necrosis factor-alpha (TNF-α) and interleukin-8 (IL-8).Results Compared with T0,serum levels of TNF-α and IL-8 significantly increased at T3 and T5 in all the three groups (P ＜ 0.05).Compared with group C,serum levels of TNF-α and IL-8 significantly decreased at T3 and T5 in group D2 (P ＜ 0.05).There was no significant difference in the indexes mentioned above between group C and group D1 (P ＞ 0.05).Conclusion Dexmedetomidine 1 μg/kg given before anesthesia induction and then infused at the rate of 0.5 μg· kg-1 ·h-1 during operation can reduce inflammatory responses in patients undergoing OLV.

Objective:To analyze the effect that right dexmedetomidine for anesthesia induction period on the hemodynamics and respiratory function in patients undergoing radical resection of esophageal carcinoma.Methods:120 cases patients of esophageal carcinoma radical resection were randomly divided into observation group and control group and 60 cases in each group, the control group was given conventional anesthesia and intravenous infusion of normal saline, and the observation group was given routine anesthesia and intravenous infusion of right dexmedetomidine. Compared two groups patient’s hemodynamics and respiratory function changes before induction of anesthesia (T0), after induction 10 min (T1), during intubation (T2), after intubation 30 min (T3), after extubation 30min (T4) at each time point.Results:(1) The observation group’s MAP of T1, T2, T3 and T4 were significantly lower than the T0. The control group’s MAP of T1, T3, T4 were significantly lower than the T0, and lower than the same period of the observation group, but T2 was significantly higher, it’s higher than the T0 and the same period of the observation group, The difference was statistically significant;The observation group and control group’s HR of T1, T3, T4 were significantly lower than the T0, and T2 increased, there were obvious than the observation group that the T1, T3, T4HR reduced, and T2 increased of the control group, so the difference was statistically significant, The dynamic curve change of HR and MAP in the observation group was less than the control group; (2)The observation group’s RR of T0, T1, T2, T3, T4 were stable, and there was no significant difference in the time period, There was significant difference in the RR of the control group at each time period, T2 was significantly higher than T0, and higher than the same period of the observation group, T3, T4 significantly lower than T0, and lower than the same period of the observation group, the difference was statistically significant; The SpO2 of T0 ,T1, T2, T3, T4 in the observation group were stable, and there was no significant difference in the time period, the control group T2, T3, T4 SpO2 significantly lower than T0, and lower than the same period of the observation group, the difference was statistically significant, T2 especially significant, the dynamic curve change of RR and SpO2 in the observation group were less than the control group.Conclusion:Right dexmedetomidine will help to improve the stability of the hemodynamic and respiratory function during induction of anesthesia in patients with radical resection of esophageal carcinoma.