Effects Of Different Dosages Of Dexmedetomidine On Muscular Relaxation Of Cisaccuronium

Objective:To observe the effect of cisatracurium on muscle relaxant effect by using different concentrations of dexmedetomidine under total intravenous anesthesiaMethods:In a prospective,randomized,double-blinded study,a total of Sixty patients scheduled for radical gastrectomy under general anesthesia,aged 40-60 years,ASA grade I^II,were randomly divided into three groups?20 in each group?.Patients were admitted to the operating room continuous monitoring of cuff blood pressure?NIBP?,heart rate?HR?,electrocardiogram?ECG?,pulse oximetry?SpO2?,nasopharyngeal temperature,bispectral index value?BIS?.Routinely establish one side of the upper extremity venous access,given conventional rehydration,the contralateral upper extremity hand connected to the closed loop muscle relaxant target control injection system electrode monitoring muscle relaxants,and set the parameters used in advance.The mice were anesthetized with pre-injection of dexmedetomidine 1.0?g/kg?D1 group?,dexmedetomidine 0.6?g/kg?D2 group?and 0.9%sodium chloride solution?C group?injection completed within10min.After the end of pre-injection use of midazolam 0.05mg/kg,sufentanil 0.5?g/kg,etomidate 0.3mg/kg start induction of anesthesia,until the patient disappeared eyelashes,loss of consciousness,the closed-loop muscle relaxation injection system to start scaling,Intravenous infusion of atracurium 0.15mg/kg(3 times ED₉₅)was started after calibration was completed,and common single-lumen endotracheal tube was inserted when muscle relaxation monitoring T₁=0.Intraoperative pump propofol and remifentanil to maintain the depth of anesthesia,propofol pump speed of 5¹0mg/kg/h,remifentanil pump speed of 4¹2?g/kg/h,and according to Vital signs of the two drugs to adjust the infusion rate,the intraoperative BIS value maintained at between 40 to 60,end-tidal carbon dioxide partial pressure(P_ETCO₂)at 35⁴5mm Hg,nasopharyngeal temperature of not less than36?,muscle relaxation monitoring site so that skin temperature>32?.The onset time of muscle relaxant?cisatracurium pump to the end of T₁=0?,the time of first priming,the time of clinical action,the recovery index and the recovery time of muscle relaxant were recorded?TOFR 0.2,0.5,0.7,0.9?After recording the patient into the operating room?T0?,pre-injection of dexmedetomidine or saline?T1?,before intubation?T2?,1min after intubation?T3?,5min T5)mean arterial pressure?MAP?and heart rate?HR?.Results:1.The onset time,the first time of drug increase,clinical duration,recovery index of cisatracurium,as well as muscle relaxation recovery time at each time point of 3groups showed no statistically significant difference?P>0.05??2.The MAP and HR in D1,D2 and C groups were not significantly different at T0 time point?P>0.05?,but at the time points of T1,T2,T3 and T4,HR and MAP differences were statistically significant in D1,D2 and C groups?P<0.05?Conclusion:The different concentrations of dexmedetomidine didn't affect the onset time,the first time of drug increase,clinical duration and recovery index In the total intravenous anesthesia.