Application Of Dexmedetomidine In Breast Augmentation

Objective:The study was designed by a single blind,randomized,controlled trial,propofol,sufentanil combined with local tumescent anesthesia and dexmedetomidine combined with propofol,sufentanil combined with local swelling anesthesia were used for breast augmentation in two ways,evaluation of the safety and effectiveness of dexmedetomidin in breast augmentation.Methods: This study was approved by the medical ethics committee of the hospital,all patients or clients know and sign a letter of consent.From the American Society of anesthesiologists(ASA)grade I or II grade 60 cases of patients with breast augmentation,Weight from 45 to 65 Kg.They were 20-45 years old.They had no hypertension,coronary heart disease and diabetes.There was no history of long-term drug abuse.There was no history of snoring or sleep apnea syndrome,history of airway operation,and history of head and neck radiotherapy,Mallampati grade I-II grade.They were randomly divided into D group and C group,30 cases in each group.Group D was combined with dexmedetomidine,propofol and fentanyl combined with local tumescent anesthesia.Group C was combined with propofol and fentanyl combined with local tumescent anesthesia.Two groups were observed and recorded before injection of(T0),pre injection of dexmedetomidine(T1),respectively after swelling after anesthesia(T2),at the beginning of the operation(T3),when stripped of pectoralis major muscle(T4),at the end of operation(T5),heart rate(HR),average arterial blood pressure(MAP),bispectral index(BIS),oxygen saturation(Sp O2)changes.Records of two groups of operation time and recovery time,the dosage of propofol and fentanyl,cardiovascular adverse events,fentanyl induced respiratory depression,when the number of cases of choking cough response and recovery period of chills,nausea and vomiting and intraoperative awareness of adverse reaction,and satisfaction of patients and surgeons.Results:1.There was no significant difference in operative time and recovery time between the two groups(from the end of surgery to the correct time to open their eyes to answer their names and age).The difference between the two groups was not statistically significant(P> 0.05).The dosage of propofol and fentanyl in group D was 29.2% and 28.5% less than those in group C(P<0.05).2.The comparison of the monitoring values of vital signs at different time points in the two groups of patients:(1)Compared with the heart rate(HR)in the two groups,the HR in group D was slower than that in group C(P<0.05).(2)Compared with the average arterial pressure(MAP)in the two groups,the D group was lower than the T1 and T2 in group C(P<0.05),and there was no statistical difference in MAP(P>0.05)at T3-5.(3)Compared with the two groups of patients with electroencephalogram double spectrum index(BIS),the BIS value of group D was lower than that of group C(P <0.05)compared with group C(P<0.05).There was no statistical difference in BIS between T2-5 and P>0.05).(4)The difference of blood oxygen saturation(Sp O2)between the two groups was not statistically significant(P>0.05)at each time point Sp O2.3.The comparison of adverse reactions: Compared with group C,the incidence of restlessness,ephedrine usage,assisted breathing times,fentanyl induced cough,intraoperative awareness,recovery and chill and vomiting in group D were significantly lower than those in group B(P <0.05),In group D,there were 5 cases of bradycardia that had to be corrected by atropine.There were no serious consequences.There was a statistically significant difference from group C(P<0.05).4.The satisfaction of patients and doctors in group D was significantly higher than that in group C(P<0.05).Conclusions: Dexmedetomidine combined with propofol and fentanyl combined with local swelling anesthesia is safe and effective for breast augmentation surgery,it can significantly reduce the dosage of propofol and fentanyl during operation,so as to maintain hemodynamic stability,reduce complications and improve the satisfaction of doctors and patients,which is conducive to the smooth operation.However,it is not recommended for patients with cardiopulmonary disease or preoperative assessment of difficult airway,or under tracheal intubation,general anesthesia and intensive care.