Effects of different doses of dexmedetomidine on circulatory fluctuations,depth of anesthesia,muscle relaxation and safety in adrenal pheochromocytoma resection
Objective To investigate the effects of dexmedetomidine(DEX)in different doses on circula-tion fluctuation,anesthesia depth,muscle relaxation and safety during adrenal pheochromocytoma resection.Meth-ods A total of 78 patients undergoing adrenal pheochromocytoma resection in Shangqiu First people's Hospital and and the First Affiliated Hospital of Zhengzhou University from Sep.2020 to Sep.2022 were prospectively select-ed and divided into two groups with 39 cases in each group by random number table method.The 0.2 μg group were given 0.2 μg·kg-1·h-1 DEX 30min before general anesthesia induction,and the 0.4 μg group were given 0.4 µg·kg-1·h-1 DEX 30min before general anesthesia induction until tumor vessels were completely clamped.The time cycle fluctuation(heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation(SpO2)),anesthesia depth,muscle relaxation effect,anesthesia recovery,vasoactive drug use and safety of the two groups were com-pared.Results After induction of anesthesia and the end of surgery,HR in the 0.4 μg group was(92.73±9.58)bpm and(84.39±8.65)bpm,both lower than HR in the 0.2 μg group of(103.57±6.91)bpm and(91.53±7.27)bpm,respectively.MAP was(85.30±4.29)mmHg and(80.45±6.38)mmHg,both lower than MAP in the 0.2 μg group of(96.35±5.88)mmHg and(84.92±5.19)mmHg,respectively.After tumor resection,HR and MAP were(80.22±7.30)bpm and(77.46±7.10)mmHg,both higher than the HR and MAP in the 0.2 μg group of(75.14±5.82)bpm and(73.92±6.03)mmHg,respectively(P＜0.05).NI immediately after endotracheal intubation in the 0.4 μg group was(52.23±5.40),lower than that in the 0.2 μg group(58.78±5.92)(P＜0.05);The onset time in the 0.4 μg group was(91.00±10.00)s,earlier than that in the 0.2 μg group(105.00±12.00)s(P＜0.05);SAS score at tracheal extubation in the 0.4 μg group was 5(4,5),lower than that in the 0.2 μg group(4,3,4)(P＜0.05);The doses of phentolamine,norepinephrine,and nitroglycerin in the 0.4 μg group were(2.64±0.35)mg,(60.42±8.57)μg,and(102.00±12.31)μg/kg·min,respectively,all lower than those in the 0.2 μg group(3.79±0.44)mg,(78.70±10.28)μg,and(113.25±19.67)μg/kg·min(P＜0.05).There was no significant difference in the total incidence of adverse reactions between the 0.4 μg group and the 0.2 μg group(P＞0.05).Conclusion The use of 0.2 μg·kg-1 h-1 and 0.4 μg·kg-1 h-1 DEX in the resection of pheochromocytoma has high safety.The lat-ter has better anesthetic effect,can reduce the dose of vasoactive drugs,improve the state of muscle relaxation,and help maintain the stability of circulation.
Adrenal pheochromocytomaDexmedetomidineCyclic fluctuationSedation-agitation scoreMuscle relaxationDepth of anesthesiaRecovery time
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