Effects Of Intravenous Anesthesia Combined With Dexmedetomidine On Blood Glucose And Insulin Secretion In Non-Diabetics Patients

Objective:To observe the effects of intravenous anesthesia combined with dexmedetomidine on blood glucose and insulin secretion in non-diabetics patients undergoing anesthesia..Methods:40 patients undergoing elective lumbar spine surgery under general anesthesia,were randomized into two groups:A group（intravenous anesthesia group）and B group（intravenous anesthesia combined with dexmedetomidine）.The group A received intravenous injection of midazolam 0.05 mg/kg,sufentanil 0.3⁰.4 ug/kg,cisatracurium besilate 0.2 mg/kg,and propofol 1.5 mg/kg for anesthesia induction.During the surgery,the group A received continuous intravenous pump injection of propofol 4¹2 mg/kg/h combined with remifentanil0.25⁰.5μg/kg/min for anesthesia maintenance.The patients in group B was infused 1μg/kg dexmedetomidine 10 minutes before operation and followed by an infusion at a rate of 0.4μg/kg/min untile 30 minutes before the end of surgery,anothers same to group A.Intraoperative BIS value was maintained at 40-60.The anesthetic dosage and body fluid in the two groups of patients were recorded.The HR,MAP,BIS value,glucose（Glu）,C peptide,insulin（Ins）and cortisol（Cor）concentrations were determined before anesthesia（T₀）,5min after tracheal intubation（T₁）,1h during operation（T₂）,2h during operation（T₃）and 15min after tracheal extubation（T₄）in the two groups of patients.Results:（1）There was no statistical difference in general information between the two groups（P>0.05）.Compare with group A,the urine output were increse in the group B（P<0.05）.（2）There were no statistical differences in the operative level,the operating time and the anesthesia time between the two groups of patients.Compare with group A,the propofol and remifentanil consumption was reduce in the group B.（3）From T₁ to T₃,the HR and MAP in group B was lower than that in group B;the HR,MAP and BIS value in both groups of patients were decreased at T₁,T₂ and T₃ compared with T₀（P<0.05）,but rose at T₄to close to those at T₀（P>0.05）.（4）Compared with T₀,the concentration of glucose and insulin at T₁-T₃ in the two group were decreased,at T₄ were elevated（P<0.05）.Compared with T₀,the cortisol at T₁-T₃ in the A group were decreased,at T₄ were elevated,and were higher than those in the group B（P<0.05）.There was no statistical difference in C peptide between the two groups of patients（P>0.05）.Conclusion:There is no effects of intravenous anesthesia combined with dexmedetomidine on blood glucose and insulin secretion in non-diabetics patients undergoing anesthesia.Intravenous anesthesia combined with dexmedetomidine could stabilize the hemodynamics and reduce the stress response in non-diabetics patients.It is a useful method of anesthesia..