Patient-controlled Sedation with Dexmedetomidine in Application of Combined Spinal Epidural Anesthesia for Pan-hysterectomy

FAN Guo-yi; HAN Zhi-qiang

doi:10.3969/j.issn.1002-3429.2016.12.027

Abstract：Objective To investigate effectiveness and safety of patient-controlled sedation with Dexmedetomidine in application of combined spinal epidural anesthesia for panhysterectomy. Methods A total of 120 patients undergoing panhys-terectomy during January 2013 and December 2015 were divided into Dexmedetomidine group ( n =60 ) and control group (n=60) according to random digits table method. All the patients were treated with combined spinal epidural anesthesia and basal anesthesia, while Dexmedetomidine group was added with patient-controlled sedation with 4 μg/ml Dexmedetomidine hydrochloride, and initial loading dose was 2 ml, and a single dose was 0. 5 ml, and locking time was 30 s, and the mainte-nance dose was 1. 5 ml/h. Intraoperative doses of Morphine and Lidocaine, intraoperative and postoperative changes of heart rate and mean arterial pressure, operation time, intraoperative bleeding loss, postoperative early anxiety score and patient sat-isfaction were compared between the two groups. Results Compared with those in control group, in Dexmedetomidine group, values of heart rate were significantly decreased at 5 min, 10 min and 30 min after the medication, the ending of surgery and 6 h after the operation ( P<0. 05 ); dosage of intraoperative Morphine and Lidocaine was decreased ( P<0. 05 ); score of state anxiety rating scales at postoperative 6 h was significantly decreased (P<0. 05);degrees of patient satisfaction were sig-nificantly improved (P<0. 05). There were no significant differences in operation time and intraoperative bleeding loss be-tween two groups. Conclusion Patient-controlled sedation with Dexmedetomidine can help maintain stable hemodynamics, reduce dosage of narcotic drugs and relieve early anxiety symptom.