Xiang Zhen,Wei Siwei,Yu Eryou,et al.Effects of different doses of dexmedetomidine on monitoring the depth of anesthesia during general anesthesia of sevoflurane in children[J].Journal of Clinical Pediatric Surgery,,22():361-366.[doi:10.3760/cma.j.cn101785-202205085-012]
Effects of different doses of dexmedetomidine on monitoring the depth of anesthesia during general anesthesia of sevoflurane in children
- Keywords:
- Dexmedetomidine; Sevoflurane; Administration &; Dosage; Anesthesia and Analgesia
- Abstract:
- Objective To observe the effect of different doses of dexmedetomidine (dex) on the depth monitoring of anesthesia during general anesthesia of sevoflurane in children.Methods For this prospective study,120 children aged 6-12 years with ASA grade Ⅰ-Ⅱ underwent elective general anesthesia plus sacral canal anesthesia for cryptic penile reconstruction and urethroplasty plus penile flexion correction from July 2020 to February 2022.They were randomized into four groups of C (normal saline),D1 (Dex 0.25 μg·kg-1·h-1),D2 (Dex 0.5 μg·kg-1·h-1) and D3 (Dex 0.75 μg·kg-1·h-1)(n=30 each).All of them were induced by an inhalation of sevoflurane and anesthesia under sacral tube block under ultrasonic guidance after laryngeal masking.Dex was recorded at pre-Dex (T0),5 min post-Dex (T1),at the start of operation (T2),15 min after the start of operation (T3) and 30 min after the start of operation.Depth of anesthesia was monitored at 9 timepoints,including T4 at 30 min post-operation,T5 at the end of operation,T6 at the time of laryngeal mask removal,T7 at the time of eye movement and T8 at the time of orientation recovery.Etsevoflurane concentration (ETsevo),mean arterial pressure (MAP) and heart rate (HR) were recorded at all intraoperative timepoints.The children and their families were followed up at Day 2 post-operation to check whether or there was any intraoperative awareness or other postoperative mental and behavioral changes.Results Intraoperative anesthesia depth (BIS value) of four groups:BIS value group declined more markedly in group D3 at T1/T2/T3/T4/T5 than that in group C/D1 (P<0.05); BIS value at T4/T5 was significantly lower in group D3 than that in group D2 (P<0.05).No significant difference existed in BIS value between groups D1 and C at T0 to T8 (P>0.05).ETsevo changes in four groups:At T1/T2/T3/T4/T5/T6,ETsevo was significantly lower in group D2/D3 than that in group C/D1 (P<0.05).Except for T2,ETsevo was not significantly different at T0/T1/T3/T4/T5/T6 in group D1 from that in group C (P>0.05).No significant difference existed between groups D2 and D3 (P>0.05).Hemodynamics at different timepoints in four groups:as compared with group C,MAP declined markedly at T3/T4/T5/T6 in group D1/D2/D3 (P<0.05); HR was significantly lower in group D1/D2/D3 than that in group C at T3/T4/T5/T6 (P<0.05).HR was lower in group D3 than that in group C/D1/D2 at T3/T4/T5/T6/T7/T8 (P<0.05).None in four groups showed any intraoperative awareness or postoperative mental and behavioral changes.Conclusion In children,continuous intraoperative injection of Dex 0.25 μg/kg/h does not affect the monitoring of sevoflurane depth of anesthesia.And continuous Dex infusion >0.5 μg/kg/h may boost the intraoperative depth of anesthesia of sevoflurane.
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Memo
收稿日期:2022-5-29。
基金项目:湖南省自然科学基金(S2019JJQNJJ0583)
通讯作者:杜真,Email:meggyzhen@163.com