Abstract：Objective To compare the anesthetic effect of propofol combined with dexmedetomidine or fentanyl in ultrasonically guided percutaneous microwave coagulation therapy (PMCT) for hepatocellular carcinoma (HCC). Methods Forty HCC patients (ASAⅠ-Ⅱ) were allocated randomly to two groups with 20 cases each. The patients in group F received intravenous anesthesia with fentanyl combined with propofol, and the patients in group D received intravenous anesthesia with dexmedetomidine combined with propofol during PMCT for HCC. The consumption of propofol, recovery time, BP, HR, SpO2 and complications were assessed. VRS and patient’s satisfactions were assessed at 30 minutes after PMCT. Results The consumption of propofol in group D decreased more than that in group F (P<0.01). The recovery time in group F decreased more than that in group D (P<0.01). The changes of SBP, DBP and HR were more in group F than those in group D (P<0.05). The incidences of bradycardia, hypotension, apnoea and injection pain in group F were higher than those in group D (P<0.05). At 30 min after PMCT, VRS in group D decreased more than that in group F (P<0.01). The patient’s satisfactions in group F decreased more than that in group D (P<0.05). Conclusions Propofol combined with dexmedemidine or fentanyl provides satisfactory anesthesia for the operation of HCC with ultrasonically guided PMCT, but anesthesia with dexmedemindine increases recovery time and patient’s satisfactions, decreases consumption of propofol and adverse reactions, and has less effect on the respiratory and circulatory function than that with fentanyl.
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Fan T W, Ti L K, Islam I. Comparison of dexmedetomidine and midazolam for conscious sedation in dental surgery monitoread by bispectral index[J]. Br J Oral Maxillofac Surg, 2013,51(5):428-433.
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Hsu Y W, Cortinez L I, Robertson K M, et al. Dexmedetomidine pharmacodynamics: part Ⅰ: crossover comparison of the respiratory effects of dexmedetomidine and remifentanil inhealthy volunteers[J]. Anesthesiology,2004,101(5):1066-1076.
2014, Vol. 25 
