关键词: 高血压, 酮咯酸氨丁三醇, 右美托咪定

Abstract: Objective To analyze the application value of ketorolac tromethamine combined with low-dose dexmedetomidine in patients with hypertension undergoing upper abdominal surgery under general anesthesia and its effect on perioperative blood pressure control. 
Methods In total, 100 hypertensive patients undergoing upper abdominal surgery treated were selected and divided into different groups according to randomized controlled principles. Group A (n=50) was given combined conventional general anesthesia, group B (n=50) was given intravenously 60 mg ketorolac tromethamine at 10 min before anesthesia induction, and a small dose of dexmedetomide (0.5 μg·kg-1·h-1) was injected in the meantime until 25 min before suture. The duration of surgery, duration of anesthesia, time to recovery and time to extubation of the two groups were recorded and compared. The mean arterial pressure (MAP), heart rate (HR), blood pressure, cerebral metabolic indexes and serum marker levels of patients at different time points were compared. 
Results There was no significant difference in duration of surgery, duration of anesthesia and time to extubation between the two groups (P＞0.05). The time to recovery of group B was shorter than that of group A (P＜0.05). The differences of interaction between groups, time points and time points between groups were statistically significant in terms of MAP, HR, systolic blood pressure (SBP) and diastolic blood pressure (DBP) between the two groups (P＜0.05). The difference of interaction between groups, time points and time points between groups were statistically significant with respect to CERO2 and Da-jvO2 between the two groups (P＜0.05). The difference of interaction between groups, time points and time points between groups were statistically significant with respect to S100-β and BDNF between the two groups (both P＜0.05). The difference of interaction between groups, time points and time points between groups were statistically significant with respect to VAS and Ramsay scores between the two groups (P＜0.05). There was no significant difference in the incidence of adverse reactions between group A and group B (12.00% vs. 16.00%) (P＞0.05). 
Conclusion Ketorolac tromethamine combined with low-dose dexmedetomidine can maintain stable hemodynamics and blood pressure in patients with hypertension undergoing upper abdominal surgery, and has few effects on brain metabolism and cranial nerves, which is safe and reliable. 

Key words: hypertension, ketorolac tromethamine, dexmedetomidine