Effects Of Different Doses Of Metoprolol On Cardiovascular Responses Of Hypertension Patients To Tracheal Extubation

Objective In the resuscitation of anesthesia, the stimulus from airway secretion,aspiration tube and endotracheal tube to the upper airway mucous membrane will cause severe bucking and blood vessel reaction such as BP rise,HR speed and ICP rise. To the hypertensive patient, it may cause severe consequence such as heart muscle ischemia,myocardial infarction or accident of cerebral vessels. In a word,extubation is a dangerous factor of perioperative. To observe the effects of different does of metoprolol on cardiovascular responses of hypertension patients at the tracheal extubation.Methods The 80 patients were randomly divided into 4 groups undergoing elective surgery. Before the tracheal extubation , patients received 5ml saline(groupA),metoprolol 0.02mg/kg(groupB),0.04mg/kg(groupC), 0.06mg/kg (groupD) respectively and then the trachea was extubated 5 min later, systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) Were recorded at premeditation, tracheal extubation, and 1.3.5 min after the tracheal extubation. Rate-pressure product was derived from SBP*HR.Results The SBP, DBP, HR, RPP of the patients in Group A increased significantly at the tracheal extubation compared with those in group A (P < 0.01), The SBP, DBP, HR, RPP of patients in group C, D decreased significantly at the tracheal extubation compared with those in group A and B (P < 0.05), and the SBP, DBP, HR, RPP of patients in group C. D decreased significantly at 1 min after tracheal extubation compared with those of patients in group A (P < 0.01). The SBP, HR, RPP in group C. D decreased significantly at 3 min after the tracheal extubation compared with those in group A (P < 0.05),Compared with premeditation, The SBP, RPP in group C, D decreasedsignificantly at 3-5 min after the tracheal extubation(P<0.05), but two patients in group D had a bradycardia after receiving metoprolol.Conclusion metoprolol of 0.04 mg/kg and 0.06mg/kg may effectively control cardiovascular responses of high pressure patients to the tracheal extubation, but 0.04 mg/kg is safest.