The Effects Of Dezocine On Sevoflurane Inhalation Induction Inelderly Patients

objective: This research is to observe the effect of dezocine to haemodynamics, stress changes and intubation adverse reactions, etc. of senior patients when used in tracheal intubation induced by sevoflurane inhalation, and to compare it with sufentanil, so as to provide a feasible method of induction for senior patients. Methods: Randomized controlled trial was adopted, 80 senior patients who were more than 65 years old with ASAⅠ- Ⅱfor selective operation were selected, and divided into 4 groups: Group A(injected intravenously with 10 ml normal saline), Group D1(injected intravenously with 0.1mg/kg dezocine), Group D2(injected intravenously with 0.2mg/kg dezocine) and Group S((injected intravenously with 0.3μg/kg sufentanil). 10 minutes after the injection, the patients inhaled oxygen 6 L/min+8% sevoflurane for induction under general anesthesia. After losing consciousness, the patients were given assisted ventilation, and after the BIS value was lower than 60, they were injected intravenously with 0.1mg/kg Cisatracurium, and received trachea intubation 5 minutes later. In the process of induction, mean arterial pressure(MAP), heart rate(HR),saturation of pulse oxygen(Sp O2) and Electrical double frequency index(BIS) before injection(T1), 10 min after injection(T2), after the inhalation induction and before intubation(T3), 1min after intubation(T4) and 10 min after intubation(T5) were recorded; blood samples were drawn at T1, T4 and T5 for blood glucose(GLU) and free cortisol(FC) detection; the time from the injection to the successful first insertion(Ta), end-tidal sevoflurane concentration after intubation(MAC value) as well as the related adverse reactions were recorded.Results:Ⅰ. Haemodynamics: 1. as to MAP, comparisons among the 4 groups at the same time showed that, there was only difference at T4; as to paired comparisons according to group for different time points: there was only difference for T4: Group A>D2 and Group S, Group D1>Group D2 and Group S; as to paired comparisons according to time for different groups, except for Group A, MAP for other three groups showed that: T2 and T3<T1. 2. As to HR, there was no difference for comparisons among the four groups at the same time point as well as paired comparisons according to group for different time points; as to paired comparisons according to time for different groups, where for Group D1 and Group D2: T2, T3 and T5<T1, Group D2: T3<T2, with differences.Ⅱ. Stress reaction: paired comparison of FC according to time for the 4 different groups showed that: for Group A, T4>T1; for Group D1, T1>T4>T5; for Group D2, T1>T4>T5; for Group S, T1>T4 and T1>T5, with differences. 2. As to GLU, paired comparison according to time(3 time points) for the 4 different groups showed that: for Group A, T1>T4, T1>T5;for Group A1, Group D2 and Group S, T1>T4>T5, with differences. Ⅲ. Induction related adverse reactions: paired comparisons of BIS according to time for the 4 different groups showed that: for each group: T1 and T2>T3, T4 and T5, p<0.05.After intubation, there was no difference for total induction time(Ta) of the 4 groups of patients and Group D2 can reduce MAC value of sevoflurane inhalation compared with Group A.In this research, Sp O2 of all patients at the induction period maintained at 92%-100%, and no induction related reverse reaction was observed. Conclusion:0.2mg/kg dezocine combined with sevoflurane inhalation induction has stable haemodynamics and small adverse reaction, which can be used for senior patients’ tracheal intubation after induction of general anesthesia; the inhibition on intubation stress such as Cardiovascular reaction and FC, etc. shall be stronger than that of the simple inhalation group and 0.1mg/kg dezocine group. However, 0.2 mg/kg dezocine group is similar to 0.3μg/kg sufentanil group in terms of intubation stress inhibition.