The Effect To CSI And Hemodynamics Of Patients Using DEX (1ug/kg) With Propol,Remifentani (Sufentanil) In General Anesthesia During The Orthopaedic Surgery

Objective: Observe the effects to CSI,hemodynamics and adverse effects of patients using DEX(1ug/kg)with propol,remifentani(sufentanil)in general anesthesia during the orthopaedic surgery.Method: 34 ASA I-II patients scheduled for orthopedic surgery were randomly divided into two groups: 1ug/kg dexmedetomidine injection given before induction of anesthesia within 15 minutes as test group(group A),the equal volume of 0.9% sodium chloride injection given as the control group(group B).Method of anesthesia: 8ml/kg compound dextran was intravenous injected after patients into the operating room.Group A: 1ug/kg dexmedetomidine injection was given before induction of anesthesia within 15 minutes at constant speed,then take conventional anesthesia induction.Group B: equal volume of 0.9% sodium chlorideinjection was given before induction of anesthesia within 15 minutes.Induction of anesthesia: midazolam 0.02-0.03mg/kg,etomidate 0.2-0.3mg/kg,sufentani 0.5ug/kg and cis-atracurium0.2mg/kg.After 3 minutes of oxygen nitrogen discharge using visual laryngoscope to endotracheal intubation and set IPPV,set pxygen flow to 2L/min,ratio of inspiratory and expiration to 1:2,and keep the PETCO2 to 35-40 mm Hg.Maintenance of anesthesia: Inject propofol with Marsh model of target-controlled infusion and Remifentanil injectiong with ECC(effectcompartment concentration)model.Stop the injection of propofol infusion 10 minutes before the end of surgery,and stop the remifentanil 5 minutes before the end.Monitoring indicators: hemodynamics indicators(HR,SBP,DBP),cerebral state index(CSI),the usage amount of propofol,sufentani in each groups,adverse effects,and VAS,Ramsay.Set the moment points:baseline value(T1),5 minutes after injection(T2),after injection(T3),before intubation(T4),3 minutes after intubation(T5),immediately after skin incision(T6),intraoperative maximum blood pressure(T7),immediately extubation(T8),10 minutes after extubation(T9).Results: There were no statistically significant differences among the two groups in sex,age,height,weight and BMI(P>0.05).The heart rates of group were lower than group B at T3,T4,T4,T7 and T8,P<0.05.The MAP of group was lower than group B at T4,T5,T7,T8.CSI of group A was lower than group B at T2,T3.Ramsay of group A was higher than group B.The usage of propofol and remifentanil of group A was significantly less than group B.There were no statistically significant differences among the two groups in VAS,P>0.05.Conclusion: Dexmedetomidine(1ug/kg)given with propofol and remifentanil used in general anesthesia of orthopedic surgery can reduce pain and anxiety before surgery,and have good sedative and analgesic effects,redue the usage of narcotic drugs.There is also anti-sympathetic with DEX to reduce adverse reactions of intubation and extubation,ensure the stability of hemodynamics in patients at the perioperative period.