Yixin Guo1#, Zhigang Chen2#, Dengguo Xiang3*
1Department of Anesthesiology, Fifth Hospital in Wuhan, Wuhan, 430050, China - 2Department of Anesthesia and Pain, Wuhan Xinzhou District People's Hospital, Wuhan, 431400, China - 3Department of Anesthesiology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, 445000, China
Objective: To investigate the effect of dexmedetomidine (Dex) on cyclical stability during escharectomy in patients with extensive burns.
Methods: The clinical data of 60 patients with extensive burns in the Fifth Hospital in Wuhan from May 2019 to June 2021were retrospectively analyzed. The patients were divided into an observation group and a control group, with 30 cases in each group. The observation group was pumped with 1 μg/kg Dex 15 minutes before anesthesia induction, then was pumped with 0.5μg·kg-1·h-1, the control group was pumped with the same dose of normal saline; both groups were given the same anesthesia scheme. The operation related indexes of the two groups were compared; hemodynamic indexes [mean arterial pressure (MAP), heart rate (HR)] were measured before dexmedetomidine infusion (T0), 10 minutes after anesthesia induction (T1), at the end of operation (T2) and 5 minutes after extubation (T3) and compared between the two groups; sedation and recovery were compared between the two groups; the adverse reactions were counted.
Results: There was no statistically significant difference in comparison of operation time and blood loss in both groups (P>0.05); there was no statistically significant difference in comparison of HR and MAP in both groups at T0 (P>0.05); the HR and MAP levels at T1, T2 and T3 of the observation group were lower when compared with the control group (P<0.05); HR and MAP were compared in both groups at each time point (P<0.05); compared with the control group, the time of eye-opening, stimulus-response recovery, and orientation recovery in the observation group was shorter, and the Sedation Rating Scale (Ramsay) score was higher (P<0.05); the incidence of adverse reactions in the observation group was lower when compared with the control group (P<0.05).
Conclusion: Dex can stabilize blood pressure and HR, improve sedation and recovery, reduce the adverse excessive stress, and is beneficial to circulation stability during escharectomy in patients with extensive burns.
severe large area burn, escharectomy, dexmedetomidine, cyclical stability.