Dexmedetomidine Or Dezocine Anesthesia For Surgical Drainage Borehole Effect Evaluation

Dexmedetomidine(DEX)is a kind of A2 receptors with high selectivity of A2 adrenergic receptor agonists,the alpha 2,alpha 1 selectivity is about1600:1,as assistant drug,widely used in the area,local and general anesthesia.DEX has the effect of sedation,analgesia and amnesia,it can also reduce the heart rate,heart rate and blood catecholamine content.It is important to use in critically ill patients and reduce the hemodynamic instability.But for short of Neurosurgery,dexmedetomidine midazolam set has a neuroprotective effect,can reduce cerebral blood flow,reduced cerebral metabolism and intracranial pressure,effectively reduce the degree of swelling of the cerebral tissue during surgery,for patients to provide a better surgical field and reduce the incidence of postoperative hypertension and avoid the occurrence of postoperative adverse events.But DEX analgesic effect than opioid drugs,dezocine belongs to opioid receptor agonist antagonist,is a K receptor agonist,u receptor antagonist agent.Dezocine through cerebrum,brainstem and spinal cord K receptor agonist and central analgesia,sedation and mild respiratory inhibition,analgesia and morphine.At the same time,the U receptor antagonist,u receptor induced nausea,vomiting,a certain inhibitory effect.Addiction is small.The combination of the two,strengthen the sedative effect,and avoids the shortage of DXM analgesia,while reducing the amount of opioid drugs dezocine,alleviate the inhibition of respiration.Objective Under local anesthesia drilling drainage surgery is safe and effective for evaluation of dexmedetomidine,dezocine,and contrast between the two combined before and after of patients with central nervous system,respiratory and circulatory system,calculate the minimal drug combination effect of the system,to evaluate combined medication superiority,including operation effect on vital signs of patients and postoperative recovery in patients with,recovery.Method Choose neurosurgical anesthesia for intracranial hematoma;drainage surgery patients with 150 cases as the object of study,older than 18 years old,less than 65 years of age,weight 40kg~80kg.Preoperative without serious heart and lung disease,ASA I ~ II grade,the research object is divided into group I: dezocine group,dexmedetomidine group and combination group,each 25 cases in each;[II] group: Dexmedetomidine set group 1,dexmedetomidine set 2 group,dexmedetomidine set 3 groups of 25 cases of dezocine group(control group)(group I).Group I: dezocine group operation started 10 min before the given dezocine load 10mg;dexmedetomidine group in preoperative 10 min given dexmedetomidine fixed loading dose of 1 g / kg,infusion time over 10 min,after in order to maintain 0.1-0.7 g /(kg-h);combined treatment group operation started 10 min before the given dezocine 5mg static drop(by Meng Fei burette)was administered dexmedetomidine loading dose of 0.5 g / kg,infusion time longer than 10 min,in order to maintain 0.1-0.7 g /(kg-h).Group [II]: Dexmedetomidine group 1,group 2,group 3.Three groups of patients were preoperative 10 min to give a loading dose of DEX 1 ug / kg,infusion time longer than 10 min,after dexmedetomidine set group 1 to maintain 0.1 0.3 g /(kg-h);dexmedetomidine set two groups to maintain 0.3-0.5 g /(kg-h);dexmedetomidine set three groups to maintain 0.5-0.7 g /(kg-h).Record [I] in the surgical group started 10 min before(T0),skin incision(T1),after the start of the 15 min(T2),operation at the end of the(T3)of three groups of patients heart rate,blood pressure,Ramsay score(sedation score),intraoperative with degree,three groups of patients with blood glucose,plasma epinephrine and plasma to norepinephrine(NE),plasma cortisol concentration,operation recovery score and hypotension,sinus tachycardia bradycardia,respiratory depression and other adverse reactions;recording [II] group in hypotension,sinus tachycardia slow,respiratory depression,recovery is extended in the incidence of each group.Statistical analysis was performed using SPSS19.0 statistical software.Results 1.More support and comparison between the comparison between the comparison of the three groups of surgery in t0 the DBP,SBP,map,HR,Sp O2 no statistical difference(P > 0.05),while in T1,T2,T3,combined treatment group the SBP,map and HR were lower than dextromethorphan group was significantly lower than that of dezocine group.The three groups had statistical difference(P < 0.05);T3 dextromethorphan group and DBP decreased,and the other two groups had statistical difference(P < 0.05);the third group Sp O2 no statistical significance,the three groups of patients with the degree of comparison,the combined group dexmedetomidine MI group,the difference was statistically significant(P < 0.05),the United States the right to the MI group do not match the number of cases with dezocine group had no significant difference(P > 0.05).2.Three groups of operation in T1,T2,T3 levels of blood glucose(BS)slightly elevated,plasma epinephrine(E),plasma to norepinephrine(NE)and the plasma cortisol(COR)concentration decreased,but three groups showed no significant difference(P > 0.05)3.dezocine group,dexmedetomidine group and combination group were breathing recovery time,call the goggle time combination group breathing recovery time than dezocine group was significantly shorter(P < 0.05),combination group in postoperative orientation force recovery time,answer questions pertinent to the question time,sedation score is better than that of the other two groups(P < 0.05);three groups of restlessness occurred rate compared with no significant difference(P > 0.05).4.[II] group centre right dexmedetomidine midazolam set group 1 patients with hypotension,sinus tachycardia bradycardia,respiratory depression,recovery to extend the rate of at least,the difference has statistical significance.(P < 0.05).5.Conclusions 1.Dexmedetomidine set combined with dezocine in neurosurgical anesthesia trepanation and drainage,can provide more comfortable sedation and analgesia for patients,a significant increase in surgery under local anesthesia in neurosurgical patients of pain tolerance,increased in patients with the degree of cooperation.2.Dexmedetomidine set combined with dezocine in local anesthesia trepanation and drainage operation,than a single with two drugs better maintain the stability of hemodynamics and three ways of drug are on blood glucose,plasma catecholamines,cortisol concentration effect of slight.3.In neurosurgical anesthesia drilling drainage surgery combined with dexmedetomidine and dezocine and in postoperative recovery does not increase the recovery time does not increase the incidence of adverse reactions of the patients after operation.4.The combination of the two drugs,to give patients with dezocine 0.1 mg / kg,dexmedetomidine set in 0.1~0.3ug/kg/h,on the patient's breathing,circulation influence minimum.