Effects Of Different Dose Of Dezocine On The Reaction During The Extubation In Elderly Patients With Hypertension Undergoing General Anesthesia

Background: the most majority of primary hypertension accounted for hypertensionwith high blood pressure, is characterized by "cardiovascular syndrome", oftenaccompanied by a variety of other risk factors, which can cause heart, brain andkidney and other target organ damage, and even the development of multiple organfunction decline. At present, with the acceleration of population aging,elderlyhypertensive patients on the increase. During extubation in general anesthesiaoperation refers to the end of gradually reducing, until tracheal extubation after aperiod of time, with patients gradually awakening will change with the changes ofhemodynamics and other indicators, general anesthesia in elderly hypertensivepatients with extubation should maintain the stability of hemodynamics, reduce thestress response, ensure perioperative safety.Dezocine as the opioid mixed agonist-antagonist, to metabolism with the form ofglucuronide conjugates, have powerful spinal analgesia with effect, can produce mildsedation and respiratory depression, addiction is small. Can be used for analgesia inadvance, postoperative pain relief and reduce stress reaction.Objective: the aim of this study was to observe the different dose dezocine on theeffects of general anesthesia in elderly hypertensive patients with extubation, andexplore the best dosage, to provide theoretical basis for clinical therapy.Methods:80elderly patients with hypertension undergoing abdominal operation, age65-85years old, gender not limited to, ASA grade II~III. Were randomly divided into4groups,20cases in each group. Give saline or different dose dezocine immediatelywith closing abdomen according to different groups: control group (group Control, C):1ml normal saline, low dose dezocine in group (D1group):50ug/kg, middle dosedezocine in group (D2group):100ug/kg, high dose dezocine in group (D3group):150ug/kg. Observe patients at different times with BIS, MAP, HR, SPO2, PetCO2,record the patient’s Ramsay sedation scores and modified Aldrete scores, and recordthe incidence of adverse reaction with follow-up in2h after.Results: The general data in each group had no significant difference(P>0.05).BIS and MAP in each group at T1, T2decreased significantly compared tothe preoperative at T0, BIS in D3group at T3-T5was obviously lower than othergroup; MAP in D2group at T2、T3was lower than C group,the difference wasstatistically significant (P <0.05).MAP in D3group at T2-T5was obviously lowerthan C group. The HR in D1, D2,D3group at T2-T5was lower than that in C group.The SpO2in D3group at T4, T5was significantly lower than C group and thePetCO2was higher than that in group C.The time from stopping operation to extubation and stay in PACU was longerthan that in other groups (P<0.05).The Ramsay sedation score of patients in D3group at T5was significantlyhigher than that in C group (P<0.05), and the modified Aldrete score in D3group wassignificantly lower than that in C group when patients access PACU.The number of patients with supplementary treatment in C and D1groupduring extubation was significantly more than the other groups, the number ofpatients with respiratory depression and dizziness in D3group was more than anyother group.Conclusion: dezocine has analgesic and mild sedative effect, middle dose dezocinecan effectively reduce the stress reaction to extubation of the elderly hypertensivepatients, improve the hemodynamic stability, and is worth popularizing in clinicalapplication.