Application effect comparison of different doses of dexmedetomidine combined with sevoflurane in trachea cannula for maintaining autonomous respiration due to difficult airway in obese patients

Objective To compare the application effect of different doses of dexmedetomidine combined with sevoflurane in trachea cannula for maintaining autonomous respiration due to difficult airway in obese patients. Methods 40 obese Patients with difficult airway from May 2014 to May 2015 were selected and randomly divided into group a,group b,group c and group d,10 cases in each group.Geoup a was given tracheal intubation on awakening,group b was given tracheal intubation by 0.6 μg/kg dexmedetomidine combined with sevoflurane,group c was given tracheal intubation by1.0 μg/kg dexmedetomidine combined with sevoflurane,tracheal intubation by 1.2 μg/kg dexmedetomidine combined with sevoflurane.Systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR) and score of bucking in prior intubation before anesthesia(T0),instant intubation(T1),3 minutes after intubation(T2),and 5 minutes after intubation(T3),the occurrence rate of adverse event during intubation among four groups was compared. Results There was no significant difference in the level of systolic blood pressure(SBP),diastolic blood pressure(DBP) and HR at T0 among four groups(P0.05).There was no significant difference in the level of SBP,DBP and HR during T1,T2 and T3between group a and group b(P0.05).The level of SBP,DBP and HR during T1,T2 and T3in group c and group d was lower than that in group a and group b,with significant difference(P0.05).The score of bucking in prior intubation in group c and group d was lower than that in group a and group b,with significant difference(P0.05).The OAA/S sedation score after operation at 5 min in group b,group c and group d was lower than that in group a,with significant difference(P0.05).There was no significant difference in the OAA/S sedation score after operation at 5 min among group b,group c and group d(P0.05).There was no significant difference in the OAA/S sedation score after operation at 10,15 min among four groups(P0.05). Conclusion Intravenous infusion of dexmedetomidine(1.0 μg/kg /kg or 1.2 μg/kg /kg) and sevoflurane for maintaining autonomous respiration in intubation by general anesthesia can effectively inhibit cardiovascular response and alleviate the adverse reaction of bucking during intubation,the side effect of 1.0 μg/kg dexmedetomidine is slight and safety is more probable,meanwhile,the time to draw tube by general anesthesia and awaking time are not affected.