Feasibility of using dexmedetomidine combined with propofol for conization of cervix

AIM To investigate the feasibility of using dexmedetomidine(Dex) combined with propofol for conization of cervix.METHODS Seventy-five ASAⅠorⅡpatients undergoing conization of cervix were randomly divided into three groups(n=25 each):control group(group C),low-dose Dex group(group D_1), high-dose Dex group(group D_2).The patients of the three groups were infused with 10 mL sodium chloride injection,Dex 0.4 mg·kg~(-1),Dex 0.8 mg·kg~(-1) slowly by micro pump 15 min before surgery.Then,all the patients were target controlled infused with propofol.The target concentration of propofol was adjusted according to the reaction of patients and the diversification of bispectral index(BIS) to maintain the appropriate depth of anesthesia.The patients were infused low-dose fentanyl when it is necessary.Index of respiration and circulation,adverse reaction and recovery time were recorded.The time points of recording were into the operating room,local anesthesia,beginning of operation,10 and 20 min during surgery,at the end of operation and patients regained consciousness.RESULTS There was no significant difference in duration of surgery,emergence time among the three groups(P 0.05).The c,.of propofol,dose of propofol and fentanyl of group D_2((1.5±0.4) mg·L~(-1),(184±54) mg,(28±11)μg) were significantly lower than those of the group C((2.2±0.3) mg·L~(-1)(259±59) mg,(75±21)μg,P0.01) and group D_1((2.0±0.4) mg·L~(-1), (234±41) mg,(42±16)μg,P 0.01).Dose of fentanyl in the group D_1 was lower than that in the group C (P 0.05).The pulse oxygen saturation of group D_2 were maintained better,but many patients of group C and group D_1 appeared respiratory depression.There were 14 and 4 patients who needed oropharynx parichnos or assisted ventilation in the group C and group D_1,respectively.The incidence rate of hypotension was more higher in the group C than that in the group D_1 and group D_2(10 patients vs.5 patients and 2 patients,P 0.01). Otherwise,the incidence rate of bradycardia was more higher in the group D_2 than that in the group C and group D_1(12 patients vs.2 patients and 7 patients,P 0.05).CONCLUSION Using Dex combined with propofol not only decreases dose of propofol and fentanyl,but also maintaines indexes of respiration and circulation more stabilizible in conization of cervix.