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| Effect of different doses of dexmedetomidine administered by nasal spray before laparoscopic myomectomy |
| General Hospital of Armed Police Corps, Jiaxing, Zhejiang Province, 314000 |
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Abstract Objective: To investigate the effect of different doses of dexmedetomidine in patients undergoing laparoscopic myomectomy. Methods: From January 2018 to December 2018, 120 patients who experinced laparoscopic resection of uterine fibroids under grade I-II elective general anesthesia evaluated by American Society of Anesthesiologists (ASA) were included and randomly divided into the group A and the group B according to random number table (60 cases in each group). 45 minutes before anesthesia induction, the patients in group A were given 1.0μg/kg dexmedetomidine by nasal spray, while patients in group B were given 0.5μg/kg dexmedetomidine by nasal spray. Before and after tracheal intubation and anesthesia induction, the hemodynamic changes, plasma concentrations of epinephrine (E), norepinephrine (NE), and cortisol (Cor) at various time points of patients in the two groups were recorded. And the cough response rate, agitation score, and improved alert sedation score (MOAA/S) during extubation, the occurrence of adverse reactions after surgery, the operation time, as well as the amount of propofol used during operation of all patients were observed. Results: There were no significant differences in HR and MAP at different time points (T0, T0-2 and T0-3) after dexmedetomidine given by nasal spray of patients between the two groups (P<0.05).In group B, the HR and MAP of patients at T2, T3 and T4 were significant higher than those at T1 (P<0.05). In group A, the MAP of patients at T2 was significant higher than that at T1 (P<0.05). The HR and MAP of patients in group B at T2, T3 and T4 were significant higher than those of patients in the A group (P<0.05). The levels of E, NE and Cor at T2 were significant higher than those at T1 in both group at T1. The plasma levels of E, NE and Cor at T2, T3 and T4 of patients in group B were significant higher than those at T1，and those were significant higher than those of patients in group A (P<0.05). The cough response rate, agitation score, MOAA/S, and amount of propofol used of patients in group A were significant lower than those of patients in group B (P<0.05). There was no significant difference in the operation time between the two groups (P>0.05). Conclusion: The patients are given 1.0 μg/kg dexmedetomidine by nasal spray before anesthesia induction during laparoscopic resection of uterine fibroids can effectively inhibit the stress response during extubation, can maintain hemodynamic stability, reduce cough response, alleviate postoperative pain, and reduce the dasage of intraoperative anesthetics, which is beneficial to the rehabilitation of patients.
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