The Effect Of Dexmedetomidine On The Rocuronium Brominde Neuromuscular Blocking Effect In Diabetic Patients

Objective: To explore the effect of dexmedetomidine on diabetic patients in the muscle-relaxing effects of rocuronium.Methods: Eighty patients undergoing selected surgery,aged 40~65,with BMI of 20~25kg·m-2 and ASA ? or ?,were divided into four groups(n=20 each),control group(group C),diabetes group(group DM),non-diabetes patients with dexmedetomidine group(group CD),and diabetes patients with dexmedetomidine group(group DD).Patients in group CD and group DD received dexmedetomidine 0.5 ?g·kg-1 intravenously in 10 minutes.Then all groups were induced by conventional anesthesia,connected and calibrated with muscle relaxation monitor.The monitoring site is the abductor pollicis muscle,by TOF mode.Patients were infused with rocuronium at a dose of 0.6 mg·kg-1.The respirator with tidal volume 8~10ml·kg-1 and the breathing rate 10~14 counts per minute,and the I/E date of 1:2 was used for patients to breath.Propofol and remifentanil were given during operation to maintain anesthesia in the four groups.Group DD and group CD were given propofol,remifentanil and dexmedetomidine during operation to maintain anesthesia.The MAP,HR and Sp O2 of the patients in each group were observed and recorded.The onset time,maintain time,recovery time of T1,T2,T3 and T4 and the time of T1 turn to 25%,50%,90% and the TOF ratio for different time periods were recored.Results:1 Comparison of vital signs in each group.After 1 min and 3 mins at the tracheal intubation,the blood pressure of patients in group CD and group DD was lower than that in group C(P<0.05).Before the tracheal intubation and after 1min and 3min at the tracheal intubation,the heart rate of patients in group CD and group DD was lower than that in group C(P<0.05).2 Comparison of muscle relaxant detection in each group.The onset time,maintain time,the time of T1 turn to 25%,50% and 90% in group DM and group DD were longer than those in group C(P<0.05);the onset time,maintain time,the time of T1 turn to 25%,50% and 90% in group DD were shorter than those in group DM(P<0.05).3 Comparison of recovery time of T1,T2,T3 and T4 of rocuronium in each group.The recovery time of T2,T3 and T4 in group DM and group DD were longer than those in group C(P<0.05);the recovery time of T2,T3 and T4 in group DD were shorter than those in group DM(P<0.05).4 Comparaison of TOF ratio over different time span in each group.After Rocuronium was injected to patients 30 minutes later,TOF ratio in group DM and group DD was less than those in group C(P<0.05).And after 40 minutes later,TOF ratio in group DD was more than that in group DM(P<0.05).Conclusion:1 Compared with the normal people,the muscle relaxant effect of rocuronium in diabetes was enhance.And the onset and recovery time of rocuronium in diabetes was delayed.2 Dexmedetomidine can suppress muscle relaxant effect in diabetes with the use of rocuronium,and shorten the onset and recovery time of rocuronium in diabetes.