Effect Of Dexmedetomidine Combined With Nitroglycerin On Controlled Hypotension In Orthognathic Surgery

Objective To observe the effect,safety and adverse reactions of dexmedetomidine combined with nitroglycerin in controlled hypotension during orthognathic surgery.Methods A total of 60 patients undergoing orthognathic surgery were selected for controlled hypotension.All patients were randomly divided into two groups,with an average of 30 cases in each group.The observation group was given dexmedetomidine combined with nitroglycerin,and the control group was given normal saline combined with nitroglycerin.Observation group were pump injected dexmedetomidine after tracheal intubation butthe control group received the same amount of saline.Both groups were all pump injected nitroglycerin 10 minutes before cutting the upper jaw,according to the mean arterial pressure adjusting pump injection speed,to make the target MAP induced by 30%,but not less than 60 mm Hg.At the end of the main operation steps started stitching stop nitroglycerin pump injection.The invasive mean arterial pressure(MAP)and heart rate(HR)of patients at different nodes were recorded.The time of reaching the target blood pressure,recovery time of blood pressure after drug withdrawal,intraoperative blood loss,nitroglycerin,and postoperative time of tube removal were recorded.Postoperative complications including chills,restlessness and sore throat were observed.Results The difference of MAP and T1 between the two groups at T2-T5 time is statistically significant(P<0.05).There was no significant difference in MAP comparison at T2-T5 time between the two groups(P>0.05).The HR of T2-T5 in the observation group was significantly lower than that in the control group at the same time(P<0.05).There were significant differences between the two groups in the time of lowering blood pressure and the dosage of nitroglycerin(P<0.05),the time of recovery,the amount of blood loss during operation and the time of extubation after extubation were compared between the two groups(P<0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion The effect of dexmedetomidine combined with nitroglycerin on controlled hypotension in orthognathic surgery is satisfactory.It significantly slows the heart rate response induced by nitroglycerin hypotension and reduces the adverse reactions during the convalescence period.