Effects of Different Doses of Dexmedetomidine on Tracheal Intubation Stress Response in Elderly Patients with Hypertension / 中国药房

ABSTRACT

OBJECTIVE:To observe the effects of different doses of dexmedetomidine on tracheal intubation stress response in elderly patients with hypertension. METHODS:A total of 105 elderly hypertensive patients who underwent selective general anes-thesia with tracheal intubation were selected from our hospital during Jun. 2014-May 2016,and then divided into group A,B,C according to random number table,with 35 cases in each group.Three groups received general anesthesia,Dexmedetomidine injec-tion 0.3,0.6,1.0 μg/kg by intravenous infusion and Remifentanil injection 0.5 μg/kg 15 min before intubation.After 10 min of ad-ministration,3 groups stopped drug infusion and received tracheal intubation fiberoptic bronchoscope. Mean arterial pressure (MAP),heart rate(HR),blood pulse oxygen saturation(SpO2),respiratory rate(RR)were observed in 3 groups at 5 min after entering surgery room(T1),immediately after infusion(T2),immediately after intubation(T3),1 min after intubation(T4),5 min after intubation(T5). Ramsay sedation scores,cough scores and intubation tolerance scores were also recorded in 3 groups at T3, and the occurrence of ADR was compared among 3 groups. RESULTS:At T1,there was no statistical significance in MAP,HR, SpO2or RR among 3 groups(P>0.05).At T2,above indexes of 3 groups were decreased significantly than at T1,with statistical significance(P<0.05);there was no statistical significance among 3 groups(P>0.05).At T3,T4 and T5,MAP,HR,SpO2and RR of 3 groups were increased significantly than at T2,and MAP and HR of group A were significantly higher than those of group B and C,with statistical significance(P<0.05). There was no statistical significance in SpO2or RR among 3 groups(P>0.05). At T3,Ramsay sedation scores,cough scores,intubation tolerance scores of group B and C were significantly higher than those of group A,with statistical significance(P<0.05). The incidence of hypertension,tachycardia,cough and restlessness in group A were significantly higher than group B and C(P<0.05),the incidence of bradycardia and respiratory depression in group C were significantly higher than group A and B,with statistical significance(P<0.05). CONCLUSIONS:Dexmedetomidine 0.6 μg/kg and 1.0 μg/kg can effectively inhibit stress response and maintain hemodynamics stable in elderly hypertensive patients during tracheal in-tubation,and dexmedetomidine 0.6 μg/kg has relatively lower incidence of ADR.