The Clinical Observation Of Dexmedetomidine With Propofol Target Controlled Infusion Applied In Anesthesia Induction Of The Elderly Hypertention Patients

Objective:To explore influence of dexmedetomidine with propofol target controlled infusion applied in general anesthesia on hemodynamics during induction and intubation of the elderly hypertension patients.Method:40ASA grade Ⅰ or Ⅱ hypertensive patients, scheduled for elective operations, were randomly divided into2groups. Group dexmedetomidine (D): intravenous dexmedetomidine0.3μg/kg, and group placebo(C):only equal volume of saline,20cases each. Group D and group C respectively received dexmedetomidine and saline by ways of intravenous infusion ten minutes before induction of anesthesia, the duration of infusion was ten minutes. The induction of anesthesia was begun with propofol3.0μg/ml by step target-controlled infusion to let patients loss consciousness, then fentanyl3μg/kg and vecuronium0.1mg/kg. Three minutes later, tracheal intubation was successfully performed within30seconds. Ventilation was adjusted to maintain an end-tidal carbon dioxide tension between35～45mmHg. Urapidil hydrochloride5mg was injected when blood pressures or heart rates had elevated30%. If the heart rate or blood pressure reductions greater than that of the base value of30%, atropine0.25mg or ephedrine5mg was administered. Systolic pressure(SBP), Diastolic pressure(DBP), mean arterial pressure(MAP) and heart rate(HR) were recorded after getting into operating room(T0), before induction(T1), before intubation(T2), at intubation(T3), at1min(T4),3min(T5) and5min(T6) after intubation.Result:①Sex ratio, age, weight, ASA records, Mallampati intubation grading, Preoperative fasting time and Infusion of ringer volume have no significant difference between two groups(P>0.05).②BP. DBP、 MBP and HR at To between two groups were not statistically significant(P>0.05). SBP. DBP. MBP and HR to patients in group D were obviously declined (P<0.05), and compared with group C, HR at each observation time were lower (P<0.05). SBP. DBP and MAP at T2were higher in group D than those in group of C (P<0.05), which at T3, T4and T5were all lower than those in group C(P<0.05). Compared to T0,SBP. DBP. MBP and HR in group C were significantly increased at T4(P<0.05). SBP.DBP.MBP and HR in group D were significantly decreased at T1than at To(P<0.05). Compared to T0,SBP. DBP and MAP in two groups at T6were significantly decreased (P<0.05),but there was no difference between two groups.Conclusion:Dexmedetomidine with propofol target controlled infusion applied in anesthesia induction of the elderly hypertention patients can effectively attenuate the stress response to tracheal intubation and make hemodynamics stability...