Characteristics of Sign Changes and Anesthesia Principles in Tracheal Extubation in Patients with Hypertension

Fu Zhenhong

Abstract：Objective To study characteristics of sign changes and anesthesia principles in tracheal extubation in patients with hypertension. Methods 97 patients with hypertension were divided into group A and group B. Normal saline and 0. 6 μg/ kg dexmedetomidine were given 30 min before the end of the surgery in the two groups. 30 patients with normal blood pressure and receiving surgery under general anesthesia were selected as group C,who were given normal saline 30 min before the end of the surgery. Surgery and anesthesia indexes(operation time,anesthetic time, dosage of fentanyl and propofol,operative blood loss,operative infusion)in the three groups were compared. The chan-ges of SBP,DBP and HR in medication(T0 ),extubation(T1 ),5 min after extubation(T2 ),15 min after extubation (T3 )and 30 min after extubation(T4 )in the three groups were analyzed. Time of breathing and restoring consciousness as well as incidence of adverse events after extubation were analyzed. Results There was no significant difference in operation time,anesthetic time,dosage of fentanyl and propofol,operative blood loss and infusion in the three groups(P﹥ 0. 05). There was no significant difference in DBP,SBP and HR in medication in the three groups(P ﹥ 0. 05). DBP,SBP and HR in group B and C were significantly lower than those in group A,and those in group B were lower than those in group C(P ﹤ 0. 05). SBP in group B and C were significantly lower than that in group A 5 min,15 min and 30 min after extubation(P ﹤ 0. 05). There was no significant difference between group B and C(P ﹥ 0. 05). DBP was significantly lower in group B and C than that in group A 5 min,15 min and 30 min after extubation. DBP in group B was lower than that in group C 5 min and 15 min after extubation. There was no significant difference between group B and C 30 min after extubation(P ﹥ 0. 05). HR in group B was lower than that in group A and C in extubation and 5 min after extubation(P ﹤ 0. 05). HR in group C was lower than that in group A. There was no significant difference in HR among the three groups 15 min and 30 min after extubation(P ﹥ 0. 05). There was no sig-nificant difference in spontaneous breathing,eye opening time,extubation time and orientation recovery time among the three groups(P ﹥ 0. 05). The incidence rate of adverse events in group A was 19. 3% , which was higher than that in group B(7. 5% )and C(10. 0% )with no significant difference(P ﹥ 0. 05). Conclusion The blood pressure of patients with hypertension receiving surgery under general anesthesia after extubation was higher than those with normal blood pressure,which may result in restlessness,severe hypertension and severe tachycardia. Injection of 0. 6 μg/ kg dexmedetomidine 30 min after operation can stabilize blood pressure and heart rate so as to reduce the incidence of adverse events,which has no influ-ence on breath and consciousness in recovery period with high clinical application value.