Effection Of Different Dexmedetomidine Delivery Modes On Extubation In Elderly Hypertension Patients

Objective:To comparison the effect of different dexmedetomidine delivery modes in the treatment of senile hypertensive patients undergoing PLIF operation during extubation period after general anesthesia.Methods:A total of 90 ASA?-?hypertension patients were enrolled in this study,aged65-78,and were divided into 3 groups of 30 patients.Group A:Dexmedetomidine 0.5?g·kg^-11 was given 30min before the end of surgery,diluted to 20ml,pumped in 15min.Group B:dexmedetomidine was given to 0.3?g·kg^-1·h^-1during surgical incision to 30min before the end of operation.Group C:No special treatment.The heart rate,MAP were observed 5min after in operaterome?T0?,before extubation?T1?,during extubation?T2?and after extubation at 1min?T3?,3min?T4?,5min?T5?,10min?T6?and 15min?T7?.Other indicators include hypotension or bradycardia during pump,reifen and propofol dosage.Time of eye-opening and extubation,rate of irritability and respiratory depression,Extubation quality score,Ramsay score at PACU,the time of Aldrete?9.Results:In group A and B,the heart rate was lower in T2-T4 than that in group C?P<0.05?,and there was no difference in other time points.The MAP of group A was lower than that of group C at each time point of T1-T7?P<0.05?and of group B at T2-T4 and T6time point?P<0.05?.The MAP of group B was lower than that of group C at T1,T2,T6,and T7 time point?P<0.05?.Lower incidence of hypotension in group B during pumping than in group A and C.The difference in the incidence of bradycardia was not significant between three groups.The dosage of remifentanil and propofol in group B was reduced by approximately 30%compared with group A and C.The difference of remifentanil consumption was statistically significant?P<0.05?.The difference in propofol dose was not statistically significant but had clinical significance.The extubation quality scores and the Ramsay score when entering PACU in groups A and B were lower than those in group C?P<0.05?.Other indexes were no significant difference between three groups.Conclusion:Both Dexmedetomidine 0.5?g·kg^-1was given 30min before the end of surgery and0.3?g·kg^-1·h^-11 pumped during surgical could relieve extubation response in elderly hypertensive patients,and slight sedation after extubation.Does not affect the recovery and adverse reaction.The former is better than the latter.