| Objective: To evaluate the effect of Dexmedetomidine in the sleep function of patients after general anesthesia.Methods: 60 patients of gastric cancer from December 2013 to December 2013 at No 1 Hospital of Shijiazhuang.All patients met the following criteria: All patients aged from 40~60 years old,ASA I~II, All patients were treated by laparoscopic radical resection surgery under general anesthesi.All patients were approved by the ethics committee of No 1 hospital of Shijiazhuang.All patients signedan informed consent.The patients were divided into three groups by a random number table:Sevoflurane group( group S, n=20), Propofol group( group P, n=20), Propofol and dexmedetomidine group( group PD, n=20). All the patients were given atropine 0.5mg im, benbabituona 0.1g im.getting a rapid path for fluid infusion before the operation.Routine monitoring tool including electrocardiogram(ECG), blood oxygen saturation line(Sp O2), radial artery puncture, invasive arterial blood pressure monitoring(ABP), central venous puncture, central venous pressure(CVP) monitoring, electrical double frequency index(BIS) monitoring, etc. Followed by intravenous injection midazolam 0.1~0.2mg/kg, sufentanil 0.6μg/kg, propofol 0.5~1mg/kg, rocuronium bromide 0.6mg/kg. The parameter Settings of anesthesia machine follows: Fi O2 = 100%, oxygen flow rate: 2 l/min, tidal volume(TV) : 8~ 10 ml/kg,(I: E) : 1:2, breathing rate(RR) : 12 times/min. Maintain blood oxygen saturation: 99 ~ 100%, maintain PETCO2 in 35~ 45 mm Hg.Group S :Monitoring patients with sevoflurane minimum alveolar concentration(MAC) effectively, 5 min before cutting the skin depth of anesthesia to achieve 1.3 MAC, operation process according to adjust the concentration of sevoflurane BIS values, intraoperative maintain the BIS value between 50 ~ 55,infused CIS atracurium 0.1mg/kg/h during the whole operation process. Group P was intravenously infused propofol 6~8mg/kg/h, remifentanil 0.1~0.2μg/kg/min and CIS atracurium 0.1mg/kg/h during the whole operation process. intraoperative maintain the BIS value between 50~ 55.Group PD was intravenously infused dexmedetomidine 0.5μg/kg/h, propofol 6~8mg/kg/h, remifentanil 0.1~0.2μg/kg/min and CIS atracurium 0.1mg/kg/h during the whole operation process.intraoperative maintain the BIS value between 50 ~ 55,10 min before the end of surgery to stop all the anesthetic. Surgery patients were sent to Post Anesthesia Care Unit(PACU)after wakeing up completely,then the patients were sent back to ward, postoperative patient controlled analgesia(PCA) to 48 hours after surgery.Result:1 All three group of patients have no differences in sex, age, BMI, operation time, amount of bleeding(P>0.05).2 The total dose of zhe propofol and zhe remifentanil had significantly different(P<0.05) between group P and group PD.3 The scores of AIS insomnia of the three groups in day 1, day 4 and day 7 had significantly different(P<0.05). The mean score of AIS in day 1, day 4 and day 7 of group P and group PD is lower than that of group S; the mean score of AIS in day 1 and day 4 of group PD is lower than that of group P. There is no difference of the mean score of AIS in day 7 between group P and group PD. Postoperative AIS Scores of the three groups in 1d,3d,7d decreased in different degrees. The Postoperative AIS Scores of the group S and group P in 4d and 7d are different from The Postoperative AIS Scores of the group S and group P in 1d significantly(P <0.05). The Postoperative AIS Scores of the group PD have no differences between 1d and 4d. The Postoperative AIS Scores of the group PD have significant differences between 1d and 7d(P <0.05). The Postoperative AIS Scores of the three group have significant differences between 7d and 4d(P <0.05).4 There are no moderate or severe pain in day 1, day 4 and day 7 after operation in three group.Conclonsion: Using dexmedetomidine as an assist of sedation can significantly improve the sleep of the patients after general asnesthesi. |
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