Application of dexmedetomidine in anesthesia of craniocerebral operation

Mei Hongxun; Xiong Wei; Han Ruquan

doi:10.3760/cma.j.issn.1673-4777.2017.03.012

Abstract：Objective To observe the effect of dexmedetomidine(DEX) on hemodynamics and quality of recovery of craniocerebral operation.Methods A total of 36 patients undergoing craniocerebral operation under general anesthesia (American Society of Anesthesiologists grade Ⅰ-Ⅱ) in Beijing Tian Tan Hospital,Capital Medical University from October 2015 to March 2016 were enrolled.The patients were randomly divided into DEX group and control group,with 18 cases in each group.The DEX group had DEX with 1 μg/kg initial loading dose before anesthesia induction and 0.3 μg/(kg · h) maintenance dose;the control group had 0.9％ sodium chloride solution 0.3 μg/(kg · h);sevoflurane and remifentanil were used for anesthesia maintenance.Postoperative extubation time,anesthesia recovery time,intraoperative remifentanil and vasoactive drugs dosages,perioperative mean arterial pressure,heart rate and bispectral index were analyzed.Results Extubation time and anesthesia recovery time had no significant differences between groups (P ＞ 0.05).The dosage of remifentanil in DEX group was significantly lower than that in control group [0.052 (0.035,0.067) mg vs 0.128 (0.050,0.231) mg] (P ＜ 0.05);the dosage of ephedrine in DEX group was significantly higher than that in control group [(1.39 ± 0.34)mg vs (0.56 ±0.12)mg] (P ＜0.05);DEX group used no esmolol,the dosage of esmolol in control group was (14±4) mg;dosages of atropine and nicardipine had no significant differences between groups (P ＞ 0.05).Mean arterial pressures at skin incision and during cranial closure in DEX group were significantly lower than those in control group(P ＜ 0.05).Heart rates after administrating loading dose,during anesthesia induction,during and after operation in DEX group were significantly lower than those in control group (P ＜ 0.05).Bispectral indexes after administrating loading dose and during cranial closure in DEX group were significantly lower than those in control group(P ＜ 0.05).Conclusion DEX can improve hemodynamic stability and reduce dose of anesthetics during craniocerebral operation.