Effects of dexmedetomidine on stress reaction during intraspinal anesthesia in elderly patients

CHEN Kunming; JIAO Xiangxue

doi:10.3969/j.issn.1002-7386.2016.13.010

Abstract：Objective To investigate the effects of dexmedetomidine on stress reaction , hemodynamics and postoperative restlessness during intraspinal anesthesia in elderly patients .Methods Eighty patients who were going to receive selective operation of lower limb orthopedics , with ASA gradeⅠor grade Ⅱ and anesthesia mode being lumbar epidural anesthesia ,were randomly divided into observation group and control group , with 40 patients in each group .Before skin incision the patients in observation group were given dexmedetomidine hydrochloride 0.5μg/kg by injection pump, with maintenance dose being 0.4μg· kg-1 · h-1,however,the patients in control group were given equivalence 0.9% sodium chloride solution by injection pump .The changes of stress reaction and hemodynamics indexes before medication (T1),after medication 10min (T2),20min (T3), 30min (T4) 60min (T5), eng of the operation (T6) were observed and compared between two groups.Results The MAP in observation group at T2,T6 was significantly lower than that in control group ,and HR in observation group at T5,T6 was significantly lower than that in control group ( P <0.05).The serum levels of NE, E and Cor in observation group at T5,T6 were significantly lower than those in control group ( P <0.05).The incidence of postoperative agitation in observation group was 12.5%, which was significantly lower than that (32.5%) in control group (P<0.05).Conclusion The dexmedetomidine hydrochloride can relieve the degree of stress reaction during intraspinal anesthesia in elderly patients , and reduce the incidence of postoperative restlessness , which is beneficial to keep the stabilization of hemodynamics .