| Objective: Different doses of Dexmedetomidine on the reaction of tracheal extubation in patients Undergoing general Anesthesia.We compare the effect of different doses of Dexmedetomidine on the reaction of tracheal extubation in hypertensive patients Undergoing general Anesthesia and the observation of adverse reaction to find the best doses for Chinese of Dexmedetomidine on the reaction of tracheal extubation.Method: 32 patients, ASA III, 3562 years old, have the Hypertension history .The patients are up to the standard after drug treatment .The surgery between 1 to 4 hours under general anesthesia .The patients are randomly divided into control group (D),0.4μg/kg group (S1),0.6μg/kg group (S2),0.8μg/kg group (S3). each of them has 8 cases. Preoperative tests and chemical examination are normol. After entering operating room, monitoring of ECG,HR,SpO2,BP are carried out on the patients, Midazolam 0.1mg·kg-1,fentanyl 2ug·kg-1,cis-Atracurium 0.1-0.15 mg·kg-1, Propofol 1-1.5 mg·kg-1 are adopted in anesthesia induction. Tracheal intubation is followed by mechanical ventilation. Maintenance of anesthesia is done by breathing in 2% Sevoflurane,pumping remifentanil into vein. The patients are given the experiment drugs 10 minites before the surgery is over .D group is given the physiological saline , S1 group is given the 0.4μg/kg DEX 50ml ,S2 is given 06μg/kg DEX 50ml, S3 is given 0.8μg/kgDEX 50ml,These drugs need to be pump in 10 minites.At the and of the surgery,stop the Sevoflurane and remifentanil.When the patients are breathing smoothly, extract the tracheal. When adapt aldret≥9 ,the patients shoule be taken to medical ward. We can record the time of entering the OR as T0,the time before anaesthesia as T1,the time 1,3,5,10 minutes after anaesthesia as T2,T3,T4,T5,T6,T7,T8,,the time before extubation as T9,the time of extubating as T10 ,and 1,3,5,10,15,20,30,60,120 minutes after extubation as T11,T12,T13,T14,T15,T16,T17,T18,T19。We record the systolic pressure(SBP), diastolic pressure(DBP), mean artery pressure(MAP),heart T0'rate(HR) and SpO2 at each point.Venous blood is collected at four time points: (before anesthesia induction), T1'(before the drugs is given ) T2'(exert the intubation ), T3'(before leave the OR). The changes of Cortisol's concentration were adopted by ELISA method. Statistical treatment is completed with SPSS17.0 package. Measurement data is expressed by mean(X)±standard deviation(s), ANOVA is used in comparison within the group, P<0.05 is considered as statistical significance. Result: 1,systolic pressure ,diastolic pressure,mean arterial pressure and Heart rate in S3 group have statistical significance compared to D group P<0.05); S1,S2 group have no statistical significance compared to D group P>0.05) ,but decrease by degrees.2 ,From T1 to T3 ,S1,S2,S3 group have statistical significance compared to D group P<0.05);.but but decrease by degrees of the Cortisol's concentration Conclusion:1. Dexmedetomidine has suppressed role on tracheal extubation in patients Undergoing general Anesthesia2. 0.8μg/kg group is better than 0.4μg/kg,0.6μg/kg group on tracheal extubation in patients Undergoing general Anesthesia...
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