Clinical Observation About Differentanesthesia Inducing Of Hypertensive Patients

Objective:During the inducing and intubation period of general anesthesia, the patient are sedate,the drug inhibits sympathetic nervus and the cardiac muscle.So the vessel dilate,the heart rate gets slow down and blood pressure are declined . And during the process of intubation because of the stimulation of laryngoscope and intubation ,the hemodynamics have a great change in the few munites.It is a extraordinary risk factor to those high blood pressure patie- nts,especially who with the cardiac and cerebral disease. When the blood pressure ascending,it may leads to severe hypertension and tachycardia.Also when the blood pressure descending,it may induce the insufficiency of blood supply of heart,brain,kidney or other important organs.How to get the appropriate anest- hesia depth during the process of intubation,and also make hemodynamics to be relatively stable.It is always a discussing topic in clinical anesthetic.This res- each aim at comparing the three different anesthesia methods to the patients with hypertension.Observe the anesthesia depth and the changes in hemodynamics.Methods:Sixty hypertensive paitents consist of 31 males and 29 females of ASAⅡwere enrolled in this study,who are undergoing selective operation,with age from 37 to 84,and who have no internal diseases.The paitents are divided into three groups randomly: Group P(propfol),Group S(sevoflure) and Group C(combine) .Each group has 20 paitents. Each group use a different way to induce. Group P:inject propfol 1.5mg/kg. Make the speed 0.5mg/s.Group S:use 7%sevoflurane in a breathing circuit,with the 6L oxygen each minute.Made the patient breath in the circuit. Group C: inject propfol 0.7mg/kg.Then use 7%sevoflurane in a breathing circuit,with the 6L oxygen each minute.Made the patient breath in the circuit. When the patients get unconscious,inject vecronium 0.10mg/kg and fentanil 4ug/kg.Use the facemask to assist the patients to breath. HR,SBP,DBP,CSI are recorded at different times of pre-anesthesia(T0), post-induce(T1) , intubation (T2) and 1 minute post- intubation (T3).All the data are shown in the form of X±S,and processed with SPSS (statistical package for social science) statistical software.Student t test is performed to get the variation between and in the groups.Result:BP:SBP and DBP are both declined in three groups in T1 compare with T0 . SBP and DBP both rise in T2 compare with T1.But there is no differentiation between T2 and T0 in the degree of BP changes in Group P. SBP and DBP both rise in T2 compare with T0 in Group S. SBP and DBP get lower inT2 compare with T0 in Group C.Among the groups, Group P has more degrees of BP decline than Group S from T0 to T1. No differentiation exists between Group S and Group C in degree of BP decline from T0 to T1. Group P aslo has no different from Group C in degree of BP decline from T0 to T1. During the T1 to T2 the BP ascends. Group P has no different from Group S in degree of BP ascend. Group S and Group P both have more rising BP than Group C. HR:The HR of three Groups goes as T1