Effects of dexmedetomidine on hemodynamics and sedation depth of sevoflurane induced tracheal intubation

YANG Fan; LIU Xingjin

doi:10.3969/j.issn.1002-7386.2017.18.006

Abstract：Objective To observe the effects of dexmedetomidine on the hemodynamics,sedation depth and bispectral index (BIS)during anesthetic induction with sevoflurane and tracheal intubation. Methods Thirty-six patients who would receive ear,nose,throat surgery were randomly divided into three groups:F2 group,F4 group and DF2 group. The heart rate (HR),artery blood pressure,oxygen saturation (Sp02)and bispectral index (BIS)were continuous monitored,moreover,the hemodynamic parameters including HR,systolic blood pressure (SBP),diastolic blood pressure (DBP)and BIS were detected immediately before administration of dexmedetomidine or saline solution (T0),immediately before anesthetic induction (T1), on 2min after anesthetic induction (T2),immediately before anesthetic intubation (T3),immediately after tracheal intubation (T4). Moreover the venous blood samples were taken,and the plasma blood glucoses (BG)levels at T0,T1,T3,T4 time points were detected. Results The levels of SBP,DBP,HR and BIS in F2 group and F4 group on T2 were significantly decreased,as compared with those on T1 (P < 0. 05),which on T4 were significantly increased,as compared with those on T3 (P < 0. 05),moreover,the levels of blood sugar on T4 were significantly increased,as compared with those on T2 (P <0. 05). The levels of SBP,HR and BIS in DF2 group on T1 were significantly decreased,as compared with those on T0 (P <0. 05),however,the levels of blood sugar were significantly increased (P < 0. 05). Moreover the levels of SBP and BIS on T2 were significantly decreased,as compared with those on T1 (P < 0. 05). As cpmpared with those in DF2 group,the levels of HR and BIS in F2 group were obviously increased on T1 (P < 0. 05),but the levels of SBP were significantly decreeased on T2 and T3 (P < 0. 05),moreover,the levels of SBP,DBP,BIS and HR were obviously increased on T4 (P < 0. 05). The levels of HR and BIS in F4 group on T1 were relatively higher (P < 0. 05),however,the levels of SBP and DBP on T2,T3 were realtively lower (P < 0. 05). Moreover the levels of blood glucose in F2 group and F4 group on T1,T3,T4 were relatively lower (P < 0. 05). As compared with those in DF2 group,the decrease extent of SBP,DBP,HR caused by anesthesia induction in F2 group and F4 group was relatively higher (P < 0. 05),however,there was no significant difference between F2 group and F4 group (P > 0. 05). As compared with those in DF2 group,the increase extent of SBP,DBP,HR caused by tracheal intubation in F2 group and F4 group was relatively higher (P < 0. 05),moreover,the increase extent of SBP and DBP in F4 group were higher (P < 0. 05). As compared with that in F2 group,the increase extent of SBP,DBP,HR in F4 group was relatively lower (P < 0. 05 ). Conclusion The dexmedetomidine can maintain hemodynamic stablity after anesthesia induction with sevoflurane and can inhibit the cardiovascular response caused by tracheal intubation to make the hemodynamic stablity during induction intubation. Moreover dexmedetomidine can decrease BIS to produce obvious sedation effects.