Objective  To assess the effectiveness and safety of dexmedetomidine (Dex) in anesthesia for end-stage renal disease (ESRD) recipients in living related renal transplantation.

  Methods  Forty ESRD patients undergoing living related renal transplantation in the Affiliated Provincial Hospital of Anhui Medical University from October 2013 to December 2014 were randomized into the Dex group and the control group, 20 patients in each group. In the Dex group, the patients were pumped with the loading dose of Dex at 0.6 μg/kg before anesthesia induction and the procedure was completed within 20 min. Then, the patients were pumped at 0.2 μg/(kg·h) for 1 h and underwent general anesthesia induction. In the control group, the patients were pumped with equivalent normal saline. The anesthesia induction and the maintenance drug of the two groups were the same. The mean arterial pressure(MAP), heart rate(HR) and bispectral index (BIS) before administration (T₀), 20 min after administration (T₁), before laryngeal mask placement (T₂) and after laryngeal mask placement (T₃) of the two groups were observed and recorded. Delayed recovery and emergence delirium were also observed. Urine output during transplantation, 4, 8, 12, 24 h after transplantation, as well as endogenous creatinine clearance rate(Ccr) before transplantation and 12, 24 h after transplantation were recorded.

  Results  Compared with T₀, the MAP, HR and BIS of the two groups at T₂ decreased significantly (all in P < 0.05). As for the comparison between two groups, the HR and BIS of the Dex group decreased significantly(both in P < 0.05), but the MAP didn't decrease significantly (P>0.05). The emergence delirium in the Dex group was all mild with the incidence of 15% (3/20), which significantly deceased in comparison with that in the control group (30%, 6/20) (P < 0.05). The urine outputs of Dex group during transplantation, and 4 h and 8 h after transplantation were significantly higher than those of the control group (all in P < 0.05). The Ccr of the two groups at 12 h and 24 h after transplantation significantly increased, compared with that before transplantation (all in P < 0.01).

  Conclusions  Dex may reduce the incidence of emergence delirium of recipient in living related renal transplantation, increase urine output after transplantation and cause no delayed recovery, which may be used in ESRD patients safely.