Application of dexmedetomidine-ketamine combined anesthesia in day surgery of breast

Abstract

Objective To study the efficacy and safety of dexmedetomidine-ketamine combination for anesthesia in ambulatory surgeries.Methods One hundred patients undergoing day surgery of breast were randomly assigned to 2 groups,dexmedetomidine-ketamine group (group D) and propofol-fentanyl group (group P),with 50 patients in each group.For each case,heart rate (HR),noninvasive blood pressure (NIBP),respiratory rate (RR),pulse oxygen saturation (SpO2) and end-tidal carbondioxide (PETCO2) were dynamically recorded.The induction time,orientation recovery time and adverse reactions were also assessed.Results No significant changes in RR,SpO2 or PETCO2 were found during anesthesia in group D (P＞0.05).Compared with the baseline values before inductions of anesthesia,RR (10±3 vs 16±4) beats/min and SpO2 (92.1±5.6 vs 98.7±1.1)％ in group P were significantly decreased after anesthesia (P＜0.05).By contrast,PETCO2 (38±6 vs 31±4) mmHg(1 mmHg=0.133 kPa) was obviously increased (P＜0.05).Futhermore,respiratory depressions were abserved in 14 patients in group P,and 0 cases in group D.Compared with group P,the patients in group D had a more stable hemodynamic status (P＜0.05).Nevertheless,the anesthesia induction time (640±102 vs 170±62) s and orientation recovery time (804±228 vs 451t162) s were longer in group D than those in group P (P＜ 0.01).Conclusions The dexmedetomidine-ketamine combination for anesthesia is effective and safe for ambulatory surgery,via delivering a stable hemodynamic status without respiratory depression. Key words: Dexmedetomidine; Ketamine; Propofol; Fentanyl; Day surgery; Breast