Effect of combined anesthesia with dexmedetomidine on intraoperative arousal quality and stress response in patients undergoing cerebral functional area surgery

Xue Yongnai; Hu Xiaoli

doi:10.3760/j.issn.1673-4777.2019.12.011

Abstract：Objective To investigate the effect of combined anesthesia with dexmedetomidine on quality grading of intraoperative arousal and stress response indexes in patients undergoing cerebral functional area surgery.Methods A total of 98 patients undergoing cerebral functional area surgery were selected from Armed Police Force Hospital of Chongqing between September 2016 and September 2018.They were randomly divided into observation group and control group,with 49 cases in each group.The observation group was intravenously injected with 0.8 μg/kg dexmedetomidine and the control group had 0.9％ sodium chloride injection at 10 min before anesthesia induction.The control group had continuous anesthesia with propofol,remifentanil and cis benzene.The observation had combined anesthesia with dexmedetomidine on the basis of the maintenance regimen in control group.Mean arterial pressure and heart rate were observed during operation.Wake-up time (cessation of propofol to waking),total dosage of anesthetics,grading of arousal quality,alertness/sedation score,plasma norepinephrine (NE) and adrenaline levels,and incidence of adverse events were analyzed.Results Mean arterial pressure and heart rate significantly increased at 30 min before waking and after waking compared to those after anesthesia induction in both groups;mean arterial pressure 30 min before waking and after waking and heart rate after waking in observation were significantly lower than those in control group (all P ＜ 0.05).Intraoperative wake-up time in observation group was significantly shorter than that in control group [(15 ± 6) min vs (19 ± 7) min] and alert/sedation score was significantly lower than that in control group[(2.3 ±0.6) vs (3.7 ±0.5)];the observation group had higher proportions of arousal quality grade Ⅰ and Ⅱ,lower proportions of grade Ⅲ and Ⅳ,and more consumptions of propofol and remifentanil(all P ＜ 0.05).Plasma levels of NE and adrenaline 5 min after waking and after operation,incidences of intraoperative adverse events such as tachycardia,agitation,elevation of blood pressure and cough in observation group were significantly lower than those in control group (all P ＜ 0.05).Conclusion Combined anesthesia with dexmedetomidine,propofol and remifentanil can significantly improve the quality of intraoperative arousal in patients undergoing cerebral functional area surgery,help to stabilize hemodynamics during arousal,reduce intraoperative stress response and adverse reactions.