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Abstract：
UNASSIGNED: This study aimed to explore the optimal dose of dexmedetomidine as a 0.59% ropivacaine adjuvant for epidural anesthesia on perioperative hemodynamics and anesthesia efficacy in patients undergoing great saphenous varicose vein surgery.
UNASSIGNED: A total of 90 patients were randomly divided into three groups: 0.25 μg/kg dexmedetomidine combined with 0.59% ropivacaine epidural infusion group (ED1 group), 0.5 μg/kg dexmedetomidine combined with 0.59% ropivacaine epidural infusion group (ED2 group), and 0.75 μg/kg dexmedetomidine combined with 0.59% ropivacaine epidural infusion group (ED3 group). Hemodynamics, anesthesia efficiency, and adverse reactions were recorded.
UNASSIGNED: Compared with the ED1 group, the ED2 group had lower systolic blood pressure at T1-3 (T1, 95%CIs, 6.52-21.93, p < 0.001; T2, 95%CIs, 2.88-18.21, p = 0.004; T3, 95%CIs, 0.49-18.17, p = 0.035), and the diastolic blood pressure at T1-2 was decreased (T1, 95%CIs, 4.55-14.36, p < 0.001; T2, 95%CIs, 0.37-12.17, p = 0.033). Compared with the ED2 group, the ED3 group had higher systolic blood pressure at T1-2 (T1, 95%CIs, 5.90-21.46, p < 0.001; T2, 95%CIs, 2.07-17.55, p = 0.008) and higher diastolic blood pressure at T1-3 (T1, 95%CIs, 2.91-12.81, p = 0.001; T2, 95%CIs, 1.32-13.23, p = 0.011; T3, 95%CIs, 0.14-11.52, p = 0.043). Compared with the ED2 group, the heart rate was significantly decreased at T1-4 in the ED3 group (T1, 95%CIs, 2.25-15.72, p = 0.005; T2, 95%CIs, 2.35-13.82, p = 0.003; T3, 95%CIs, 0.50-9.79, p = 0.025; T4, 95%CIs, 1.46-10.36, p = 0.005). The myocardial oxygen consumption in all three groups was significantly decreased at each time point compared to T0 (p < 0.05 or < 0.001), and no significant between-group differences were detected (P>0.05). Compared with the ED1 group, the anesthesia efficiency of ED2 and ED3 groups was markedly enhanced, but the risk of bradycardia in ED2 and ED3 groups was dramatically increased (6 of 28 [21.4%] vs. 14 of 30 [46.7%] and 14 of 27 [51.9%], p = 0.023), one patient in the ED3 group experienced difficulty urinating, and remaining adverse reactions were mild in all three groups.
UNASSIGNED: A measure of 0.5 μg/kg dexmedetomidine is the optimal dose as a 0.59% ropivacaine adjuvant for epidural anesthesia in patients undergoing great saphenous varicose vein surgery.
UNASSIGNED: http://www.chictr.org.cn/, registration number: ChiCTR2200060619.
UNASSIGNED: A total of 90 patients were randomly divided into three groups: 0.25 μg/kg dexmedetomidine combined with 0.59% ropivacaine epidural infusion group (ED1 group), 0.5 μg/kg dexmedetomidine combined with 0.59% ropivacaine epidural infusion group (ED2 group), and 0.75 μg/kg dexmedetomidine combined with 0.59% ropivacaine epidural infusion group (ED3 group). Hemodynamics, anesthesia efficiency, and adverse reactions were recorded.
UNASSIGNED: Compared with the ED1 group, the ED2 group had lower systolic blood pressure at T1-3 (T1, 95%CIs, 6.52-21.93, p < 0.001; T2, 95%CIs, 2.88-18.21, p = 0.004; T3, 95%CIs, 0.49-18.17, p = 0.035), and the diastolic blood pressure at T1-2 was decreased (T1, 95%CIs, 4.55-14.36, p < 0.001; T2, 95%CIs, 0.37-12.17, p = 0.033). Compared with the ED2 group, the ED3 group had higher systolic blood pressure at T1-2 (T1, 95%CIs, 5.90-21.46, p < 0.001; T2, 95%CIs, 2.07-17.55, p = 0.008) and higher diastolic blood pressure at T1-3 (T1, 95%CIs, 2.91-12.81, p = 0.001; T2, 95%CIs, 1.32-13.23, p = 0.011; T3, 95%CIs, 0.14-11.52, p = 0.043). Compared with the ED2 group, the heart rate was significantly decreased at T1-4 in the ED3 group (T1, 95%CIs, 2.25-15.72, p = 0.005; T2, 95%CIs, 2.35-13.82, p = 0.003; T3, 95%CIs, 0.50-9.79, p = 0.025; T4, 95%CIs, 1.46-10.36, p = 0.005). The myocardial oxygen consumption in all three groups was significantly decreased at each time point compared to T0 (p < 0.05 or < 0.001), and no significant between-group differences were detected (P>0.05). Compared with the ED1 group, the anesthesia efficiency of ED2 and ED3 groups was markedly enhanced, but the risk of bradycardia in ED2 and ED3 groups was dramatically increased (6 of 28 [21.4%] vs. 14 of 30 [46.7%] and 14 of 27 [51.9%], p = 0.023), one patient in the ED3 group experienced difficulty urinating, and remaining adverse reactions were mild in all three groups.
UNASSIGNED: A measure of 0.5 μg/kg dexmedetomidine is the optimal dose as a 0.59% ropivacaine adjuvant for epidural anesthesia in patients undergoing great saphenous varicose vein surgery.
UNASSIGNED: http://www.chictr.org.cn/, registration number: ChiCTR2200060619.
摘要：
■本研究旨在探讨右美托咪定作为0.59%罗哌卡因辅助硬膜外麻醉的最佳剂量对大隐静脉曲张手术患者围术期血流动力学及麻醉效果的影响。
■共90例患者随机分为3组：0.25μg/kg右美托咪定复合0.59%罗哌卡因硬膜外灌注组（ED1组），0.5μg/kg右美托咪定复合0.59%罗哌卡因硬膜外灌注组(ED2组),和0.75μg/kg右美托咪定复合0.59%罗哌卡因硬膜外灌注组(ED3组)。血流动力学,麻醉效率，并记录不良反应。
■与ED1组相比，ED2组在T1-3时收缩压较低(T1，95CIs，6.52-21.93，p<0.001；T2，95CIs，2.88-18.21，p=0.004；T3，95CIs，0.49-18.17，p=0.035），T1-2时舒张压降低(T1，95CIs，4.55-14.36，p<0.001；T2，95CIs，0.37-12.17，p=0.033）。与ED2组比拟，ED3组在T1-2时收缩压较高（T1，95CIs，5.90-21.46，p<0.001；T2，95CIs，2.07-17.55，p=0.008）和T1-3时舒张压较高（T1，95CIs，2.91-12.81，p=0.001；T2，95CIs，1.32-13.23，p=0.011；T3，95CIs，0.14-11.52，p=0.043）。与ED2组比拟，ED3组的心率在T1-4时显着降低（T1，95CIs，2.25-15.72，p=0.005；T2，95CIs，2.35-13.82，p=0.003；T3，95CIs，0.50-9.79，p=0.025；T4，95CIs，1.46-10.36，p=0.005）。与T0相比,三组各时间点的心肌耗氧量均显著下降(p<0.05或<0.001),组间差异无统计学意义(P>0.05)。与ED1组比拟，ED2和ED3组的麻醉效率明显提高,但ED2和ED3组的心动过缓风险显著增加(28人中有6人[21.4%]vs.30人中有14人[46.7%]，27人中有14人[51.9%]，p=0.023),ED3组的一名患者排尿困难，其余不良反应均较轻。
■0.5μg/kg右美托咪定作为0.59%罗哌卡因辅助用于大隐静脉曲张手术患者硬膜外麻醉的最佳剂量。
■http://www.chictr.org.cn/,注册号:ChiCTR2200060619。
■共90例患者随机分为3组：0.25μg/kg右美托咪定复合0.59%罗哌卡因硬膜外灌注组（ED1组），0.5μg/kg右美托咪定复合0.59%罗哌卡因硬膜外灌注组(ED2组),和0.75μg/kg右美托咪定复合0.59%罗哌卡因硬膜外灌注组(ED3组)。血流动力学,麻醉效率，并记录不良反应。
■与ED1组相比，ED2组在T1-3时收缩压较低(T1，95CIs，6.52-21.93，p<0.001；T2，95CIs，2.88-18.21，p=0.004；T3，95CIs，0.49-18.17，p=0.035），T1-2时舒张压降低(T1，95CIs，4.55-14.36，p<0.001；T2，95CIs，0.37-12.17，p=0.033）。与ED2组比拟，ED3组在T1-2时收缩压较高（T1，95CIs，5.90-21.46，p<0.001；T2，95CIs，2.07-17.55，p=0.008）和T1-3时舒张压较高（T1，95CIs，2.91-12.81，p=0.001；T2，95CIs，1.32-13.23，p=0.011；T3，95CIs，0.14-11.52，p=0.043）。与ED2组比拟，ED3组的心率在T1-4时显着降低（T1，95CIs，2.25-15.72，p=0.005；T2，95CIs，2.35-13.82，p=0.003；T3，95CIs，0.50-9.79，p=0.025；T4，95CIs，1.46-10.36，p=0.005）。与T0相比,三组各时间点的心肌耗氧量均显著下降(p<0.05或<0.001),组间差异无统计学意义(P>0.05)。与ED1组比拟，ED2和ED3组的麻醉效率明显提高,但ED2和ED3组的心动过缓风险显著增加(28人中有6人[21.4%]vs.30人中有14人[46.7%]，27人中有14人[51.9%]，p=0.023),ED3组的一名患者排尿困难，其余不良反应均较轻。
■0.5μg/kg右美托咪定作为0.59%罗哌卡因辅助用于大隐静脉曲张手术患者硬膜外麻醉的最佳剂量。
■http://www.chictr.org.cn/,注册号:ChiCTR2200060619。
