To Observe The Effect Of Dezocine With Etomidate For Hypertension Patients During PLMA Insertion

Objective:To observe the security, evaluate its effectiveness and feasibility of the stressreaction of inhibition of Dezocine for hypertension patients during PLMA insertion.Methods:Eighty hypertension patients undergoing elective urinary surgery in generalanesthesia，with ASA Ⅱ~Ⅲ level, were randomly divided into observation group(group D) and the control group (group F) with40cases each. Anesthesia was inducedwith Midazolam0.05mg/kg,Etomidate0.2mg/kg, Rocuronium0.6mg/kg whenconsciousnesses disappear,plusing Dezocine0.15mg/kg (group D) or Fentanyl4μg/kg(group F).To insert PLMA by the same high qualifications anesthesiologist inanesthesia induction drugs when BIS reaches to40~55. HR, MAP, NE,E,Cor andadverse reactions(such as choking cough reflex, myoclonus, poor injection pain,mouth, body movement, hiccups and laryngospasm) were recorded before injectingdezocine or fentanyl (T0) and immeadiately before insertion (T1), immediately afterinsertion (T2),at1min (T3),3min (T4) and5min after insertion (T5). Vascularactive drug usage and the conditions of LMA insertion (Class1, excellent:thelaryngeal mask is easy to insert and patient have no response;Class2, preferably:Patients with laryngeal mask when insert have a slight cough or movement;Class3,range: Laryngeal mask can insert, but there is apparent reaction, such as rough cough,retch, or laryngospasm) were recorded.Results:1.The MAP around the time of insertion were not significantly different in group D(P>0.05). The MAP in group F was lower at T1, T5and higher at T2、T3than that atT0and that in group D (P <0.05).2.The HR decreased at T1than that at T0in bothgroups, the difference was statistically significant (P <0.05). The HR in group D is smooth, after PLMA inserted.But the HR in group F was higher at T2and lower atT4、T5than that at T0and that in group D, the difference was statistically significant(P <0.05).3.The concentration of NE、E、Cor increased at T1,T2,T3,T4,T5than at T0in both group（P＜0.05）.The higher degree of NE、E、Cor is lower in group D thanin group F（P＜0.05）.4. Two groups of laryngeal mask in the rate of good conditionsin group D and group F were87.5%and82.5%respectively.There was no significantdifference (P>0.05).5.Patients with adverse reactions such as choking cough reflex,myoclonus and the injection pain in group D is less than that of group F, thedifference was statistically significant (P <0.05).6.The use of Ephedrine and Atropinein group D is less than that of group F, the difference was statisticallysignificant(P<0.05).Conclusion:1、Dezocine for laryngeal mask in hypertension patients showed inhibitory effect onthe stress response and hemodynamic stability;2、Dezocine can mitigate the injectionof etomidate be caused by pain, myoclonus;3、compared with Fentanly,the effect ofusing Dezocine is satisfactory and hypertension patients obtain a high comfort levelduring induction of general anesthesia， worthy of clinical popularization andapplication.