Impact of Dexmedetomidine total intravenous anaesthesia on obese patients

Abstract

Objective To compare the impact on the circulation function and anesthetic recovery between the obese perioperative patients with elective modi?ed radical mastectomy received dexmedetomidine total intravenous anaesthesia and the ones received remifentanil total intravenous anaesthesia; and to explore the anti-pain effect and side-effects of the two group patients. Methods In this prospective randomized double-blind study, 56 cases ASA Ⅰ～Ⅱ and age 34 ～ 60yr morbidly obese patients who were scheduled for modi?ed radical mastectomy, were allocated into two groups averagely.Dexmedetomidine group received i.v. dexmedetomidine 1 μ g/kg as preinduction within 15 minutes, then muscular to maintain anaesthesia. Record hemodynamics changes and anaesthesia drug dose during the operation. Record the anaesthetic recovery time, and observe the postoperative adverse reaction. Results Propofol-remifentanil and propofol-dexmedetomidine got similar intraoperative hemodynamic responses;the mean arterial pressure was similar in the two groups(P＞0.05), but heart rate was higher after extubation in remifentanil group (P＜ 0.05). Propofol doses for induction and maintenance of anesthesia was lower within dexmedetomidine group. The need for earliest analgesic administration was delayed, and the incidence rate of postoperative respiratory depression, nausea, vomiting, shivering were lower in dexmedetomidine group (P＜0.05); but the recovery time was longer(P＜0.05). Bradycardia was similar between two groups (P＞ 0.05). Conclusion Dexmedetomidine total intravenous anesthesia provide stable hemodynamics for the morbidly obese patients with elective modi?ed radical mastectomy; and can decrease propofol consumption and undesirable side-effects, delay postoperative analgesics requirement, but it fail to facilitate anesthetic recovery. Key words: Dexmedetomidine; Anesthsia; Obesity