Ghodki Poonam S, Thombre Shalini K, Sardesai Shalini P, Harnagle Kalpana D
Department of Anaesthesiology, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.
J Anaesthesiol Clin Pharmacol. 2012 Jul;28(3):334-8. doi: 10.4103/0970-9185.98329.
Dexmedetomidine is a highly selective α(2) agonist with properties of sedation, analgesia and anxiolysis, making it an ideal anesthetic adjuvant. Using an anesthetic adjuvant that decreases requirement of anesthetics and analgesics may predispose the patient to awareness. We monitored the depth of anesthesia (DOA) using entropy to avoid unwanted awareness under anesthesia.
30 patients, American Society of Anesthesiologists grade I and II, aged between 18 to 50 years of either gender undergoing laparoscopic surgeries under general anesthesia were studied. Loading dose infusion of dexmedetomidine was started 1 mcg/kg for 15 minutes and patients were premedicated. Routine induction with propofol and fentanyl was carried out, and maintenance infusion of dexmedetomidine 0.2 mcg/kg/hr was given. Patients were monitored with standard monitoring, and in addition, the DOA was monitored with entropy.
A 62.5% reduction (0.75 mg/kg) in the induction dose of propofol was observed, with a 30% less end-tidal concentration of isoflurane requirement for maintenance of anesthesia, while maintaining the adequate DOA.
Dexmedetomidine is an effective anesthetic adjuvant that can be safely used in laparoscopy without the fear of awareness under anesthesia.
右美托咪定是一种高选择性α(2)激动剂，具有镇静、镇痛和抗焦虑特性，使其成为理想的麻醉辅助药物。使用能降低麻醉药和镇痛药需求的麻醉辅助药物可能会使患者易发生术中知晓。我们使用熵来监测麻醉深度（DOA），以避免麻醉下出现不必要的术中知晓。
研究了30例美国麻醉医师协会分级为I级和II级、年龄在18至50岁之间、接受全身麻醉下腹腔镜手术的患者，男女不限。右美托咪定负荷剂量以1 mcg/kg输注15分钟进行预给药。采用丙泊酚和芬太尼进行常规诱导，并给予右美托咪定维持输注0.2 mcg/kg/小时。患者接受标准监测，此外，用熵监测麻醉深度。
观察到丙泊酚诱导剂量减少62.5%（0.75 mg/kg），维持麻醉所需异氟烷的呼气末浓度降低30%，同时维持足够的麻醉深度。
右美托咪定是一种有效的麻醉辅助药物，可安全用于腹腔镜手术，无需担心麻醉下的术中知晓。
