Effect Of Preoperative Dexmedetomidine On Hemodynamics During Perianesthesia Induction In Patients With Hypertension

Objective:Hypertension is one of the most common cardiovascular diseases in clinical practice.Even if the patient’s preoperative blood pressure is well controlled,hemodynamic fluctuations caused by the patient’s fear of surgery and high mental tension after entering the room will lead to cardiovascular and cerebrovascular accidents.Therefore,it is very important for the anesthesiologist to ensure the stability of the patient’s hemodynamics.Dexmedetomidine（DEX）is a new type of anesthetic adjuvant drug.Due to its unique pharmacological properties,dexmedetomidine has been widely used in the clinical anesthesia of hypertension patients.However,many domestic and foreign studies have reported little on the effect of preoperative DEX on hemodynamics during anesthesia induction in hypertension patients.The purpose of this study was to observe the effect of preoperative dexmedetomidine on hemodynamics during perianesthesia induction in patients with hypertension.Methods:A total of 50 patients with primary hypertension who underwent elective surgery under general anesthesia in the affiliated hospital of Chengde medical college from December 2017 to August 2018 were selected.The American Society of Anesthesiologists（ASA）classification was between grade II and grade III,the age was between 26 and 67 years old,and the BMI was between 18.5 and 27.5kg/m²,both male and female.All the patients had a preoperative fasting time of 12h and a prohibition of drinking time of 8h.All the patients were not given preoperative medication and were given routine oral antihypertensive drugs.According to the random distribution method,the patients were divided into two groups:group A was the experimental group,and 15ml of dexmedetomidine at A dose of0.75ug/kg was injected by micropump intravenously 10 minutes before anesthesia induction.Group B was the control group,and 0.9%sodium chloride injection（15ml）was intravenously pumped with a micro pump 10minutes before anesthesia induction.Anesthesia induction drugs and the order of induction were the same in both groups.Record two group of patients,feats of the benchmark time（T₀）,beauty’s microphones set right or injection of 0.9%sodium chloride injection pump to start（T₁）,10 minutes after anesthesia induction（T₂）before and after anesthesia induction（T₃）,immediately after intubation（T₄）,1 minutes after intubation（T₅）,3 minutes after intubation（T₇）has systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR）.Meanwhile,the utilization rates of atropine,ephedrine and uradil injection in the two groups were recorded.Results:There was no significant difference in general data such as gender,age,BMI,ASA classification and Mallanpati airway classification between the two groups（P>0.05）.In the experimental group（group A）,compared with the baseline time（T₀）at the time of entry,the SBP,DBP and HR of 10 minutes（T₁）after the start of dexmedetomidine pumping were significantly reduced（P<0.05）.SBP,DBP and HR increased slightly before anesthesia induction（T₂）,but there was no significant difference between them and baseline time（T₀）at the time of admission（P>0.05）.Compared with the baseline time（T₀）at the time of admission,SBP,DBP and HR of T3 were significantly decreased after anesthesia induction（P<0.05）.SBP,DBP and HR increased slightly after intubation（T₄）,and the difference was not statistically significant（P>0.05）.Compared with the baseline time（T₀）at the time of admission,SBP,DBP and HR decreased 1 minute after intubation（T₅）and 3 minutes after intubation（T₆）,and the difference was statistically significant（P<0.05）.Compared with the control group（group B）,SBP,DBP and HR in the experimental group（group A）showed no significant difference at T₀（P>0.05）,while SBP,DBP and HR showed significant difference at T₁,T₃ and T₄（P<0.05）.There was no significant difference in the utilization rate of atropine injection and ephedrine injection between the two groups（P>0.05）.However,the usage rate of uladil injection in the experimental group was significantly lower than that in the control group,with extremely significant statistical significance（P<0.01）.Conclusion:In patients with hypertension,preadministration of dexmedetomidine（0.75ug/kg）before surgery can reduce the stress response caused by sympathetic stimulation during endotracheal intubation,reduce the use of vasoactive drugs,make hemodynamics more stable during perianesthesia induction,and provide a safe anesthesia method for patients.