The study designed to explore the efficacy and safety of the closed loop of target controlled infusion dexmedetomidine combined with propofol for anesthesia with intraoperative wake up.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
60
1. Target Controlled Infusion propofol and remifentanil to targeted plasma concentrations are 4 μg/ ml and 4 ng/ml respectively. 2. Intermittent injection cisatracurium (0.15mg/kg). 3. A laryngeal mask airway will be placed when bispectral electroencephalogram index is reduced to 60.
1. Closed-loop target controlled infusion of propofol ,Bispectral electroencephalogram index feedback value will be set at 50. 2. Target Controlled Infusion remifentanil , targeted plasma concentrations are 3\~6ng/ml ,maintain heart rate to 60\~100 beats per minute and mean blood pressure to 70\~105 mmHg. 3. Intermittent injection cisatracurium (0.05mg/kg).
Success rate of awaken test
Time frame: The whole time of surgery,about 8 hours
The time from starting to awaken test to patient wakes up
Time frame: From starting to awaken test to patient wakes up,about 3 hours
Blood sugar concentration
Time frame: 30 minutes prior to awaken test,the moment of awake,5 minutes after awake,the moment after finish awaken test,10minutes after finish awaken test
Cortisol concentration
Time frame: 30 minutes prior to awaken test,the moment of awake,5 minutes after awake,the moment after finish awaken test,10minutes after finish awaken test
Epinephrine concentration
Time frame: 30 minutes prior to awaken test,the moment of awake,5 minutes after awake,the moment after finish awaken test,10minutes after finish awaken test
Norepinephrine concentration
Time frame: 30 minutes prior to awaken test,the moment of awake,5 minutes after awake,the moment 30 minutes prior to awaken test,the moment of awake,5 minutes after awake,the moment after finish awaken test,10minutes after finish awaken test
The duration of anesthesia from baseline to patient wake up
Time frame: From baseline to patient wake up ,about 3 hours
The dosage of Cisatracurium before patient wakes up
Time frame: From starting to awaken test to patient wakes up,about 3 hours
The dosage of propofol before patient wakes up
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
1. Stopped Closed-loop target controlled infusion of cisatracurium and propofol 30 minutes before awaken test. 2. In dexmedetomidine group,dexmedetomidine infusion rate will be reduced to 0.1 μg•kg-1•h-1. In control group ,normal saline infusion will be given with the same infusion rate as dexmedetomidine group . 3. Call patients' name and require them to move both feet every 30 seconds after patients recovered normal respiration. 4. Patients will be considered to be awake when recover normal respiration and make responsive to verbal commands correctly . 5. Patients will receive initial anesthesia after finish awaken test.
Time frame: From starting to awaken test to patient wakes up,about 3 hours
The dosage of remifentanil before patient wakes up
Time frame: From starting to awaken test to patient wakes up,about 3 hours
Heart rate
Time frame: 30 minutes prior to awaken test,the moment of awake,5 minutes after awake,the moment after finish awaken test,10minutes after finish awaken test
Mean arterial pressure
Time frame: 30 minutes prior to awaken test,the moment of awake,5 minutes after awake,the moment after finish awaken test,10minutes after finish awaken test
Bispectral electroencephalogram index
Time frame: 30 minutes prior to awaken test,the moment of awake,5 minutes after awake,the moment after finish awaken test,10minutes after finish awaken test