Abstract:

AIM: To observe the effects of dexmedetomidine on platelet activation during perioperative period in patients with coronary heart disease underwent laparoscopic surgery.  METHODS: Sixty patients of coronary heart disease who underwent laparoscopic surgery and were assessed as grade Ⅱ-Ⅲ according to American Society of Anesthesiologists (ASA) standard and gradeⅠ-Ⅱ according to cardiac function. All patients were observed without severe arrhythmia and were randomly divided into four groups according to the order of treatment: dexmedetomidine 0.4 μg/kg (group D1), 0.6 μg/kg (group D2), 0.8 μg/kg (group D3) and normal saline (group C) (n=15). Before induction of anesthesia,10 Ml dexmedetomidine infusion of 0.4 μg/kg (group D1), 0.6 μg/kg (group D2), 0.8 μg/kg (group D3) or normal saline (group C) for 10 min; four groups of patients received same anesthesia. The platelet activation markers CD62P and GPⅡb/Ⅲa were measured before, 1 h and at 2 h after administration. The blood loss was recorded and the pain severity was evaluated by VAS within 8 h after operation. Ramsay score was used to assess the degree of sedation.RESULTS:The expression of CD62P and GPⅡb/Ⅲa complexes in each group was up-regulated. Compared with group C, the expressions of CD62P and GPⅡb/Ⅲa complexes in group D1, D2 and D3 were down-regulated at T2 and T3 time points (P<0.05); D3 group was less than D1 and D2 group, and D2 group was less than D1 group. Compared with group C, the VAS scores in group D1, group D2 and group D3 were significantly lower than those in group C after the operation (P<0.05). Compared with group C, the postoperative Ramsay score was up-regulated in the D1, D2 and D3 groups (P<0.05), but there was no significant difference in the Ramsay scores between the 4th and 8th hour after operation (P>0.05).CONCLUSION:Dexmedetomidine can reduce the expression of platelet activation markers in patients with coronary heart disease during perioperative period of laparoscopic surgery. The postoperative pain score is decreased and no excessive sedation is observed.