Authors

Hao Che, Liyun Zhao#

Departments

Department of Anesthesiology, Beijing Anzhen Hospital of Capital Medical University, Beijing, PR China

Abstract

Objective: To analyse the effects of different doses of dexmedetomidine on hemodynamics, body stress response and inflammatory response in patients with refractory sinusitis undergoing endoscopic nasal surgery under general anaesthesia. 

Methods: A total of 124 patients with refractory sinusitis who underwent general anaesthesia and endoscopic surgery from May 2017 to January 2019 were randomly divided into groups receiving low, medium and high doses of dexmedetomidine and a control group, with 31 patients in each group. The low-, medium-, and high-dose groups were given 0.5, 0.8, and 1.0 μg/kg dexmedetomidine, respectively, and the control group was given an equal amount of 0.9% sodium chloride solution. Changes in the general conditions of surgery, hemodynamics, stress indicators and inflammatory factors were compared between the groups. 

Results: The anaesthesia time, postoperative extubation time and intraoperative blood loss were significantly lower in the medium- and high-dose dexmedetomidine groups compared with the low-dose group and the control group (P<0.05). The heart rate (HR) and mean arterial pressure (MAP) at time points T2 and T3 were significantly lower in the low-, medium- and high-dose dexmedetomidine groups than in the control group (P<0.05). The HR and MAP at time points T2, T3 and T4 were also significantly lower in the medium- and high-dose groups than in the low-dose group (P<0.05). The levels of cortisol, epinephrine and norepinephrine were significantly lower in the low-, medium- and high-dose groups than in the control group (P<0.05), and were significantly lower in the medium- and high-dose groups than in the low-dose group (P<0.05). The levels of TNF-α, sIL-2R and IL-6 at time points T2, T3 and T4 were significantly lower in the low-, medium- and high-dose groups than in the control group (P<0.05), and were significantly lower in the medium- and high-dose groups than in the low-dose group (P<0.05). 

Conclusion: Dexmedetomidine-assisted general anaesthesia endoscopic surgery can effectively maintain hemodynamic stability and reduce the body's stress response and inflammatory response. The evaluated dose of 0.5 μg/kg of dexmedetomidine is the safest and does not prolong extubation time.

Keywords

Dexmedetomidine, endoscopic surgery, refractory sinusitis, hemodynamics, stress response, inflammatory response.

DOI:

10.19193/0393-6384_2020_3_242