Comparison of the effects of dexmethomidine and midazolam on hemodynamic changes during extubation in patients with a history of hypertension Candidate for non-emergency orthopedic surgery

Abstract

Sympathetic stimulation following extubation in patients with a history of hypertension leads to an increase in plasma concentrations of catecholamines and as a result causes cardiovascular responses including hemodynamic response and increased blood pressure and heart rate, arrhythmia and increased myocardial requirement. Oxygen is present in patients at risk for ischemia, myocardial infarction, and hemorrhagic stroke, especially in patients whose sympathetic system responses are not well controlled (including patients with a history of hypertension) and these responses may be Therefore, we decided to conduct a study to compare the effects of dexmedetomidine and midazolam on hemodynamic changes during extubation of patients with a history of hypertension who are candidates for non-emergency orthopedic surgery. Materials and Methods: This study is a randomized clinical trial without a control group that was performed in 2021 with the participation of 100 orthopedic surgery patients in need of general anesthesia with a history of hypertension in Shohada Hospital. Patients received the relevant intervention after random allocation in two groups of midazolam (n = 50) and dexmethomedin and completion of anesthesia. Patients in the midazolam group received the drug as a bolus ten minutes before extubation at 0.02 mg / kg body weight, and patients in the dexmedetomidine group received 0.5 mcg / kg body weight per hour. Hemodynamic status was also recorded at different times and the data in SPSS 20 statistical software were compared with Chi-square and ANOVA statistical tests. Results: The prophylactic effects of dexmedetomidine and midazolam before extubation on heart rate and arterial oxygen saturation were not statistically significant (P >0.05), while systolic blood pressure and diastolic blood pressure following prophylactic injection of dexmedetodine relative to midazolam. More stability and significant were associated (P <0.05).