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The clinical research of sedative effects of dexmedetomidine for the patients with neuroleptanalgesia |
DONG Lan,HAN Shujun,LEI Zhili,LI Zhanjun,and LI Ligang. |
Department of Anesthesiology, General Hospital of Chinese People’s Armed Police Forces, Beijing 100039, China |
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Abstract Objective To investigate the sedative effects of dexmedetomidine on patients undergoing epidural block by comparing with midazolam. Methods Ninety patients were randomly divided into 3 groups, who received intravenous infusion of dexmedetomidine(D) , midazolam (M) and saline (C), separately. Patients in group D received dexmedetomidine 0.6 μg /kg as loading dose and following maintenance dose 0.5 μg /(kg·h), those in group M received midazolam 0.06 mg/kg and following 0.05 mg/(kg·h), while group C received 0.9 % normal saline. The loading dose was administered intravenously for 10 min, started as soon as analgesic effect was satisfactory, and stopped at 30 min before the end of operation. MAP, HR, SpO2 and BIS score, which were used to evaluate the sedative effects, were recorded at the basement, before administration, 5 min, 10 min, 20 min, 30 min after administration and at the end of operation. At the same time, the side effects and incidence of amnesia were recorded. Results In group D, MAP increased at T2 and T3 compared with T0, meanwhile HR decreased at T2 (P<0.05 or P<0.01), markedly at T3 and T4 (P<0.01). In group M, MAP decreased at T3 and T4 compared with T0, HR from T3 to T5 and SpO2 at T2 and T3. BIS decreased from T2 in both group D and group M (P<0.05), but significantly in group D at T4 and T5. Patients in group D had a shorter duration of BIS score down to 75 and a significantly lower suppressive rate of respiration compared with patients in group M, who had better amnesia. Conclusions Dexmedetomidine and midazolam are both suitable for sedation and amnesia to patients with epidural block, and dexmedetomidine 0.6 μg /kg as a loading dose is appropriate to patients with no respiratory suppression. As for amnesia, midazolam is better, while patients who receive dexmedetomidine have no bad memory, except some of recollection in the operation.
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Received: 27 November 2012
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