Effects of different loading doses of dexmedetomidine on palinesthesia quality of patients receiving laparoscopic cholecystectomy

doi:10.3969/j.issn.1002-7386.2018.14.016

Abstract：Objective To investigate the effects of different loading doses of dexmedetomidine medication before surgery on palinesthesia quality of patients receiving laparoscopic cholecystectomy. Methods A total of 120 patients ( ASA class Ⅰ or Ⅱ) who were scheduled for laparoscopic cholecystectomy under general anesthesia were randomly divided into four groups: group D1, group D2, group D3 and group NS, with 30 cases in each group. The patients in group D1, group D2, group D3 were given a loading dose 0. 3μg/kg,0. 5μg/kg,1. 0μg/kg of dexmedetomidine,respectively,however,the patients in group NS were given the same volume of 0. 9% sodium chloride solution via a pump within 15 minutes before anesthesia. The spontaneous breathing recovery time, eye opening time, extubation time, PACU stay time were recorded, moreover, the Ramsay sedation scores during palinesthesia period, VAS pain score, choking cough score and adverse reactions were observed. In addition the changes of mean aerial pressure ( MAP) and heart rate ( HR) were observed before anesthesia (T0),at the end of surgery (T1), at tracheal extubation (T2),at extubation after 5 minutes (T3) and out of anesthetic recovery room (T4). Results There were no significant differences in gender, age, body height and weight, anesthesia time and operation time among the four groups (P>0. 05). As compared with those before drug administration, MAP and HR at T2 in group D1 and group NS were significantly increased (P<0. 01), but the changes of MAP and HR T1, T2, T3, T4 in group D2 and group D3 were not significant (P>0. 05). Moreover there were no significant differences in MAP and HR in different time pionts between group D1 and group NS (P>0. 05),however,the MAP and HR in group D2 and group D3 were significantly decreased,as compared with those in group NS (P<0. 05). There were no significant differences in spontaneous breathing recovery time, eye opening time, extubation time between D1group ,D2 group and group NS(P>0. 05),and the PACU retention time was shorter in group D2,however, which in group D3 in corresponding time points was prolonged. In addition the Ramsay scores at 10min after extubation in group D3 were significantly higher than those in the other three groups, and VAS scores in group D2 and group D3 were significantly lower than those in group NS and group D1(P<0. 05). Besides the bucking scores and incidence rate of restless in group D2 and group D3 were significantly lower than those in group NS and group D1(P <0. 05). Conclusion A single loading dose of 0. 5μg/kg or 1. 0μg/kg dexmedetomidine medication before induction of anesthesia is able to effectively inhibit the hemodynamic response during extubation ,but 0. 5μg/kg dose can provide a better recovery quality,with fewer side effects of drugs,without effects on recovery time, therefor, which is an ideal dose for laparoscopic cholecystectomy.