Effect of dexmedetomidine combined with tramadol for patient-controlled intravenous analgesia on elderly patients with essential hypertension

Objective To evaluate the efficacy of dexmedetomidine combined with tramadol for patient-controlled intravenous analgesia on elderly patients with essential hypertension.Methods 60 ASA Ⅰ~Ⅱ elderly patients with essential hypertension,aged 65~79 year-old undergoing elective internal fixation of femoral shaft fracture under general anesthesia were randomly divided into 3 groups(20 cases in each group):groupⅠ,group Ⅱ and group Ⅲ.Dexmedetomidine 0.4 μg/kg was injected intravenously 40 min before operation ending in group Ⅱand Ⅲ while tramadol 50 mg was given in group Ⅰ.GroupⅠand groupⅡ received PCIA with tramadol 500 mg + tropisetron 5 mg in 100 mL of normal saline(background infusion at 2 mL/h with 0.5 mL and lockout interval 15 min)within 24 h after operation.Group Ⅲ received PCIA with tramadol 400 mg combined with dexmedetomidine 100 μg and tropisetron 5mg in 100 mL of normal saline respectively.VAS scores,tramadol consumption,Ramsay and satisfaction scores were recorded within 24 h postoperatively.The numbers of patients who needed urapidil,ephedrine or atropine,and sides effects,such as vomiting and respiratory depression,were recorded within 24 h postoperatively.Results The consumption of tramadol and VAS scores were significanly lower while Ramsay scores and the satisfaction scores were significanly higher in group Ⅱ and Ⅲ than those in group Ⅰ within 24 h postoperatively(P0.05).The consumption of tramadol and VAS scores and the numbers of patients who needed urapidil were significantly decreased in group Ⅲ compared with group Ⅱwithin 24 h after operation.Conclusion Small dose of dexmedetomidine combined with tramadol PCIA was safe and effective for elderly patients with essential hypertension,and it can prevent further deterioration of postoperative hypertension.