The application value of dexmedetomidine in acute coronary syndrome and PCI operation

LI Yu-zhon g; DENG Yan-na; LONG Hong-jie

doi:10.3969/j.issn.1674-3806.2015.12.07

Abstract：Objective To investigate the application value of dexmedetomidine (DEX) in acute coronary syndrome(ACS) and PCI operation.Methods Ninety-nine patients with ACS and PCI operation in our hospital from September 2008 to June 2012 were randomly divided into DEX group(n =33), propofol group (n =33) and control group(n =33).The control group received the therapy of saline infusion and the propofol group received conventional anesthesia induction therapy of propofol(1 ~2 mg/kg), and the DEX group received anesthesia induction therapy of DEX(0.5 g/kg).The levels of plasma epinephrine(E) and norepinephrine(NE) in the three groups were detected by high-efficiency chromatographic analysis method, and the levels of plasma thromboxane B2(TXB2), and 6-ketone-alpha prostaglandin F1(6-Keto-PGF1α) were detected by radioimmunity method.Visual analogue scale(VAS) was used for pain evaluation.Heart rate(HR), mean arterial pressure(MAP), VAS and the levels of E, NE, TXB2, and6 -Keto-PGF1αin plasma in the three groups were statistically analyzed before and after the surgery.Results T2 , T3 and T4 HR in the DEX group after the DEX injection were significantly lower than those in the propofol group; T2 , T3 and T4 HR in the propofol group were significantly lower than those in the control group(P <0.05).T2 , T3 and T4 MAP in the DEX group were significantly lower than those in the propofol group; T2 , T3 and T4 MAP in the propofol group were significantly lower than those in the control group(P <0.05).The levels of plasma E, NE and TXB2 in the DEX group after DEX injection were significantly lower than those in the propofol group ; The levels of plasma E, NE and TXB 2 in the propofol group were significantly lower than those in the control group; The level of plasma 6-Ke-to-PGF1αof the DEX group was higher than that of the propofol group while its VAS scores were lower than those of the propofol group; The level of plasma 6-Keto-PGF1αof the propofol group was higher than that of the control group while its VAS scores were lower than those of the control group(P <0.05).Conclusion Using DEX in anesthesia induction is beneficial to maintaining the dynamic balance of perioperative blood flow, inhibiting the body′s stress re-sponse to the perioperative blood and relieving the pain in patients with ACS during PCI.