Effects Of Dexmedetomidine On Hemodynamic Responses, Extubation Quality And Awaking Time During Tracheal Extubation For Patients With Hypertension

Objective The aim of this study was to compare the effects of different concentration dexmedetomidine and sufentanil on hemodynamic responses,airway reflexes and recovery to tracheal extubation after general anesthesia with hypertension patients.Methods Patients of this study classified as American Society of Anesthesiologists physical statusⅡorⅢwho were patients with hypertension undergoing general anesthesia. Operating time was chosed between one and four hours. Using a sealed-envelope method, the patients were randomly divided into 5 groups (6 patients per group). Thirty minutes before operation finished, patients received dexmedetomidine 0.4μg/kg(D1 group),0.6μg/kg(D2 group),0.8μg/kg(D3 group) in 20 ml of isotonic saline or sufentanil 0.1μg/kg(S group) in 20 ml of isotonic saline or 20 ml of isotonic saline (C group) intravenously. All patients were extubated by anesthesiologists who were blinded to the study drugs, and all were continuously monitored from before induction to 60 minutes after extubation. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean artery pressure(MAP) and Real Portfolio Project (RPP) were recorded before induction of anesthesia (T0),before drug administration (T1),after drug administration 1min(T2), 5min(T3),10min(T4),30min(T5),before extubation(T6),at the time of extubation(T7) and at lmin(T8),5min(T9), 10min(T10),30min(T11),60min(T12) after extubation. Spontaneous respiration recovery, open eyes, extubation, awakening and orientation times were recorded end of operation.Results Thirty patients were included in the study. There were significantly decreases in HR, SBP, DBP, MAP and RPP at T4～T10 in other 4 groups than in placebo group. Dexmedetomidine groups (D1, D2, D3) were associated with a significant decrease in extubation quality scorces compared with sufentanil group and placebo group, reflected in the prevalence of cough after extubation. The time of spontaneous ventilation, open eyes, extubation,orientation time were significantly longer in sufentanil group(S) than in the other 4 groups.Conclusion The findings in the present study suggest that dexmedetomidine group,administered before extubation, was more effective in maintaining hemodynamic stability to tracheal extubation and attenuating airway reflexes without prolonging recovery compared with sufentanyl 0.1μg/kgⅣin these patients.