The Effects Of Dexmedetomidine Conscious Sedarion Onparkinson Patients With Cerebral Deep Electric Stimulus Implantation

Objective : To discusse The security and effectiveness of dexmedetomidine conscious sedarion on Parkinson patients with deep brain electric stimulus implantation in the first period and the effect on the laryngeal mask airway general anesthesia in the second period.Methods Forty ASA?or? patients(72male,8female)aged 17~75yrs of Parkinson's Disease with selective operated bilateral subthalamic nucleus deep brain electric stimulus implantation were selected and randomly divided into dexmedetomidine group(group D)and contrast group(group C),20 cases in each group.For group D,vein pump injection of dexmedetomidine 0.5 ug/kg was done within 15 min after entering the operating room,the speed of 0.1~0.3?g·kg-1·h-1was kept subsequently until the end of the first period;To group C,the same dosage of normal saline was pump injected.The times of micro-electrode interference,tremor relief were recorded;UPDRS score 1 day before the surgery,4 weeks after the surgery were recorded;SBP,DBP,HR,SPO2,PETCO2,BIS and Ramsay sober scores of two groups of patients were recorded at the entry of operating room(T0),partial infiltration anesthesia(T1),unilateral electrode implantation(T2),contralateral electrode implantation(T3),the end of the first period(T4);the time spend for consciousness to vanish,from the beginning of the general anesthesia to implant the laryngeal mask airway,recover the spontaneous breathing and draw out the tube were recorded;the propofol,remifentanil dosage from the beginning of general anesthesia induction to the consciousness vanishes,implant laryngeal mask airway,the end of the surgery were recorded;Results: Comparing these two groups,the micro-electrodes were intervened and trembles were relieved had no statistical meaning(P=0.231),the improvement rate had no statistical meaning(P>0.05);Compared to T0,in group D,T1~T4 HR obviously reduced,BIS value obviously reduced,Ramsay score obvious increased(P<0.05);Compared to group C,from T1 to T4,SBP,DBP reduced obviously,HR slowed down obviously,BIS value obviously lowered,Ramsay score obvious increased(P<0.05),SPO2,PETCO2 had no statistical meaning(P>0.05),the time spend for consciousness to vanish,from the beginning of the general anesthesia to implant the laryngeal mask airway,recover the spontaneous breathing and draw out the tube were reduced(P<0.05),the propofol,remifentanil dosage from the beginning of general anesthesia induction to the consciousness vanishes,implant laryngeal mask airway,the end of the surgery were reduced(P<0.05).Conclusion: Dexmedetomidine sober sedative could effectively reduce the untoward effects of Parkinson patients with deep brain electric stimulus implantation in the first period,such as the rise of blood pressure,faster of heart rate,also not affect the breath,provide the excellent calmness,and not affect the surgery effects;it could reduce the anesthesia induction and awakening time of laryngeal mask airway general anesthesia and decrease the propofol,remifentanil dosage.