ZHANG Yunpeng, JI Guoyu, DONG Tianxin, DONG Long, WANG Zhixue, LI Yan. Effects of Dexmedetomidine on the Control of Blood Pressure, Hemodynamics and Inflammatory Response in Elderly Patients Undergoing Endoscopic Sinus Surgery with ASA Level I-II[J]. Chinese Journal of Modern Applied Pharmacy, 2020, 37(13): 1633-1637. DOI: 10.13748/j.cnki.issn1007-7693.2020.13.018
    Citation: ZHANG Yunpeng, JI Guoyu, DONG Tianxin, DONG Long, WANG Zhixue, LI Yan. Effects of Dexmedetomidine on the Control of Blood Pressure, Hemodynamics and Inflammatory Response in Elderly Patients Undergoing Endoscopic Sinus Surgery with ASA Level I-II[J]. Chinese Journal of Modern Applied Pharmacy, 2020, 37(13): 1633-1637. DOI: 10.13748/j.cnki.issn1007-7693.2020.13.018

    Effects of Dexmedetomidine on the Control of Blood Pressure, Hemodynamics and Inflammatory Response in Elderly Patients Undergoing Endoscopic Sinus Surgery with ASA Level I-II

    • OBJECTIVE To study the effects of dexmedetomidine on the control of blood pressure, hemodynamics and inflammatory response in elderly patients undergoing endoscopic sinus surgery with American Society of Anesthesiologists(ASA) level I-Ⅱ. METHODS Sixty elderly patients undergoing endoscopic sinus surgery with ASA level I-Ⅱ were divided into observation group and control group(n=30). The observation group was given dexmedetomidine, while the control group was given nicardipine and esmolol for the control of blood pressure during the surgery. In both groups, midazolam, fentanyl, propofol and atracurium were given for anesthesia induction. Sevoflurane and propofol were used for anesthetic maintenance. When the nasal cavity was filled, the anesthetic was stopped. Heart rate(HR) and mean arterial pressure(MAP) were monitored at three minutes before the induction of anesthesia(T0), immediate intubation(T1), and immediate extubation(T2). Fasting venous blood was collected at T0, T2, 24 h after operation(T3) and 72 h after operation(T4), and the levels of related inflammatory factors CRP, TNF-α and IL-6 were measured. The occurrence of anesthesia complications were observed and recorded during and after surgery. RESULTS There was no significant difference between the HR and MAP groups at each time point. The HR and MAP of the T1 and T2 time points were significantly higher than those of the T0, and the HR and MAP of the T2 time point was significantly higher than that of the T1(P<0.05). Ramsay score and blood pressure reduction time in the observation group were lower than those in the control group(P<0.05). The levels of inflammatory factors in the observation group were significantly lower than those in the control group(P<0.05). The inflammatory index of T0 to T3 showed an upward trend, reaching the maximum at T3, and decreasing at T4, all had statistically significant(P<0.05). There was no intraoperative awareness, respiratory depression, chills, etc. occurred during the operation, and no complications such as agitation were observed after operation. CONCLUSION Elderly patients undergoing endoscopic sinus surgery with ASA level I-Ⅱ can use dexmedetomidine to control intraoperative blood pressure and hemodynamics indicators, effectively reducing the intensity of inflammatory response.
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