Effect Of Urapidil On Bispectral Index During Tracheal Extubation Under General Anesthesia For Patients With Hypertension

Background: Hypertension is one of the major risk factors of anesthesia andsurgery. Analgesics，sedative and muscle relaxants was used reasonable and goodcontrol of blood pressure in hypertensive patients，but in the resuscitation ofanesthesia, consciousness recovery as the depth of anesthesia decreased，the bloodpressure and heart rate suddenly increased and faster in hypertensive patients becauseof sputum aspiration and extubation. Extremely unfavorable for patients withhypertension.URA is a new type of antihypertensive drug，It reduces blood pressure by thedouble unique mechanism, peripheral and central，Its hypertensive action was quickand exact effect，it will not to reduce blood pressure lowered to below the normalgenerally，antihypertensive and not increasing the heart rate，it does not affectintracranial pressure，glucose metabolism and lipid metabolism.Bispectral Index (BIS) is now well recognized reliability for monitoringsedation level.it is Increasingly wide range of applications，it can reduce theoccurrence of intraoperative awareness， intraoperative anesthetic drug dosage andalso help determine the timing of extubation，preventing extubation early or delayedbecause the effect of antihypertensive drugs on the hemodynamic disturbances inperiod of extubation.Objective: To explore a rational administration mode of URA and the influenceof BIS in order to inhibit the reaction of extubation after general anesthesia inabdominal operation hypertension.Methods: sixty ASA II–III patients with essential hypertension undergoingabdominal operation under general anesthesia, aging from50to85years old andweighing from40kg to80kg, were randomly divided into3groups，by the end of theoperation and BIS was70,3groups Were given saline, URA0.4mg/kg and the first dose intravenous injection of URA12.5mg, followed by2mg/ml until the trachealextubation. The SBP,,DBP,HR,BIS were observed and recorded at7time points, uponentering the operating room (T0), pre-administration （T1），during extubation (T2),1,3,5,10min after extubation (T3，T,4，T5，T6).Results: during tracheal extubation of essential hypertension patients，bothsingle-dose and multiple-dose of URA can inhibit the reaction of extubation，but theblood pressure and heart rate rise again when10min after extubation in the group ofURA single-dose, while multiple-dose of URA can maintain the blood pressure andheart rate in normal range better, improving safety for hypertension patients in theperiod of extubation. BIS increased degree was significantly lower than in group ofsaline.Conclusion:1Intravenous injection URA can inhibit the reaction of extubation of patientswith hypertension in period of tracheal extubation under general anesthesia.2intravenous injection URA0.4mg/kg before extubation, only can inhibit theearly extubation response of patients with hypertension in period of trachealextubation under general anesthesia, when10min after extubation the blood pressureand heart rate both showed increasing trend.3The patients with hypertension in period of tracheal extubation under generalanesthesia，first dose intravenous injection of URA12.5mg, followed by2mg/ml untilthe tracheal extubation can effectively inhibit the side reaction during trachealextubationand，keep hemodynamics stable for lasting effect.4URA0.4mg/kg before extubation and the first dose intravenous injection ofURA12.5mg, followed by2mg/ml until the tracheal extubation both inhibit BISincreasing of patients with hypertension in period of tracheal extubation under generalanesthesia.