Clinical evaluation of dexmedetomidine in anesthesia with target controlled infusion of propofol and remifentanil

Objective To observe the influence of pre-injection of dexmedetomidine (Dex) on anesthetic effects in patients undergoing target controlled infusion (TCI) of propofol and remifentanil. Methods Forty female patients scheduled for gynecological laparoscopy were randomly assigned to two groups: dexmedetomidine group (group D)and control group(group C). In group D the patiens received Dex 0.8μg/kg i.v. within 15 min.In group C received equal volume of saline.Bispectral index (BIS), MAP, HR and the values of norepinephrine (NE) and epinephrine (E) were recorded at the time points of pre-administration of Dex (T1), before induction (T2), pre-intubation (T3), intubation (T4), 3 min after intubation (T5), extubation (T6), 3 min after extubation (T7). Anesthetics consumption, anesthesia recovery, delayed respiratory depression and intraoperative awareness were recorded as well. Results Compared to those at T1 and group C, BIS scale of group D at T2 showed significant decrease (P0.01). MAP, HR in group C had a significant increase than those in the group D at T2,T4,T6 (P0.05 or P0.01). In group C, the values of NE and E were significantly higher at T4,T6 than those at T3 and group D(P0.01). The values of NE and E in group C at T4,T6 had a significant increase compared with those values in group D (P0.01). Propofol and remifentanil consumption in group D were less than in group C (P0.05). Incidence of body movement and coughing before extubation was higher in group C than those in group D (P0.01). There was no significant difference in the recovery time and eye opening with trachel extubation time from anesthesia between the two groups. Conclusion During anesthesia with TCI of propofol and remifentanil, sedative effect can be induced by dexmeditomidine 0.8 μg/kg, which can reduce stress responses and anesthetics consumption without extended recovery time from anesthesia.