| Objective: Investigating the minimum effective dosage of dexmedetomidine combined with remifentanil for the patients of inducing abortion in second trimester in order to find a reliable basis for the application of dexmedetomidine in inducing abortion in second trimester and ensure the safety of the patients during their abortion process.Method: Select pregnant women aged 18 to 45 years old,and ASA level I or II to partici pate in this experiment,After the patients entered the delivery room,their heart rate,noninvasively determined blood pressure,pulses,oxygen saturation level,respiration rate,and BIS values were routinely measured.All of the patients were provided with oxygen masks(oxygen flow rate: 2-3L/min).The drug administration was through the vein of the upper limbs.The body burden of remifentanil was at 0.5?g/kg,with continuous injection rate of 0.05?g/kg/min.Dexmedetomidine was injected simultaneously with the initial rate of 0.2?g/kg/h and for the first 26 minutes from start and the degree of sedation within the period was evaluated.The following dosage was determined with modified sequential analysis.If the previous patient was positive on conscious suppression,the dosage for the next patient was decreased by 0.05?g/kg/h,otherwise increased by 0.05?g/kg/h until there were 7 transition points between negative and positive on conscious suppression.End of study.The definition of conscious suppression can be defined by the disappearance of eyelid reflex,Ramsay sedation scale of 4,and BIS value ?70.Result: The case studies have been done on 26 patients.The ED50 and ED95 with their 95% CI for dexmedetomidine induced conscious suppression are 0.39?g/kg/h(0.32~0.61?g/kg/h)and 0.62?g/kg/h(0.48~1.95?g/kg/h).Conclusion: ED50 for the sedation effect of target control infusion of dexmedetomidine combined with remifentanil for the patients of inducing abortion in second trimester is 0.39?g/kg/h. |
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