The Effect Of Orexin-A In Promoting To Awake From Combined Intravenous-Inhalation General Anesthesia By Doxapram

Objective To investigate the awaking role of doxapram in general anesthesia and the relationship between this role and orexin-A in the lumbar surgery.Methods We enrolled 44 patients scheduled for elective lumbar surgery under combined inhalation and intravenous anesthesia between October 2015 and October 2016 in General Hospital of Ningxia Medical University.They aged from 18 to 60,body mass index rang 21 from 25 kg·m^-2,ASA physical status classification system?-?levels.They were randomly divided into 2 groups:controlled group?group C?,doxapram group?group D?.All the participants were used uniform standards to induction and maintain.Doxapram0.5mg·kg^-1 were injected in patients in doxapram group and the same volume saline in those in controlled group at the time after stopping anesthetics.We recorded two time periods:from stopping anesthetics to eyes opening?TEO?and to extubation time?ET?.Arterial blood 2.5ml was collected at the following 4 time points:preanesthesia?T₀?,1 hour after anesthesia induction?T₁?,5 minutes after tracheal extubation?T₂?,and 30 minutes after tracheal extubation?T₃?.Blood sample 2 mL was used to detect plasma orexin-A concentrations and the rest 0.5 mL to get blood glucose.Results Compared with group C,TEO and ET in group D were shorter?P<0.05?.plasma orexin-A levels were significantly higher at T₂ in doxapram group than those in controlled group?P<0.05?.No statistical differences were found about BIS and blood glucose between two groups at each time point.Compared to T₀,the blood glucose was significantly lower at T₁ and significantly increased at T₂,T₃ in both groups?P<0.05?.Conclusion Doxapram can promote the emergence from general anesthesia,in which may be involved in increase of plasma orexin-A.