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| Effects of preoperative intranasal Dexmedetomidine for the bispectral index and median effective concentration of Sevoflurane in children with abdominal surgery by inhalation anesthesia of Sevoflurane |
| LIU Chao XIN Zhong▲ |
| Department of Anesthesiology, National Center For Children′s Health, China Beijing Children′s Hospital, Capital Medical University, Beijing 100045, China |
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Abstract Objective To analyze the effects of preoperative intranasal Dexmedetomidine for the bispectral index (BIS) and median effective concentration [EC (50)] of Sevoflurane in children with abdominal surgery by inhalation anesthesia of Sevoflurane. Methods One hundred and twenty children received abdominal surgery in Beijing Children′s Hospital, Capital Medical University from February 2016 to February 2017 were selected, with ASA grading Ⅰ-Ⅱ and 1-3 years old. They were divided into study group and control group by random number table method, with 60 cases in each group, they were respectively given Dexmedetomidine 2 μg/kg and equal amounts of normal saline by nasal aerosolization device at 30 min before anesthesia induction. After the children entered operating room, they were given mask oxygen-inspiration and inhalation of 6% Sevoflurane for anesthesia induction. The laryngeal mask was given after children lost consciousness, and they were given drugs according to Dixon sequential experiment, the initial concentration was 3.50%. The setting of Sevoflurane for the next child was adjusted according to the conditions of laryngeal mask insertion of last one child. The changes of blood pressure, heart rate, BIS and the conditions of emergence agitation, adverse reactions before nasal spray (T0), 20 min after nasal spray (T1), and at the end of surgery (T2), recovery from anesthesia (T3) between the two groups were compared, the EC (50) and 95% confidence interval (CI) at the time of laryngeal mask insertion of Sevoflurane were analyzed. Results There were no significant differences of blood pressure and heart rate at T0 and T1 between the two groups (P ＞ 0.05). The blood pressure and heart rate of the study group at T2, T3 were significantly higher than those of the control group (P ＜ 0.05). There was no significant difference of BIS value between the two groups at T0 (P ＞ 0.05). At T1 and T2, BIS values of the study group were significantly lower than those of the control group (P ＜ 0.05). At T3, BIS value of the study group was significantly higher than that of the control group (P ＜ 0.05). The EC (50) at laryngeal mask insertion of Sevoflurane in the study group and the control group was 1.35% (95%CI = 1.05%-1.48%) and 1.89% (95%CI = 1.77%-2.18%), the differences were statistically significant (P ＜ 0.05). The incidence of emergence agitation in the study group was 5.00%, which was significantly lower than that of control group (18.33%) (P ＜ 0.05), the incidence of nausea and vomiting was 11.67%, 6.67% respectively, which was significantly lower than those of control group (26.67%, 21.67%) (P ＜ 0.05). Conclusion Preoperative intranasal Dexmedetomidine can reduce the agitation after inhalation anesthesia of Sevoflurane in children with abdominal surgery, which has positive effects for improving the quality of inhalation anesthesia of Sevoflurane and EC (50) of Sevoflurane, and it can effectively reduce adverse reactions.
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