方法：将90例老年白内障合并高血压手术患者随机分为两组，研究组45例在手术过程中应用静脉输注盐酸右美托咪定，对照组45例给予生理盐水静脉输注。检测两组手术前(T₀)、手术开始(T₁)、手术中10min(T₂)、手术中20min(T₃)、手术结束(T₄)五个时间点的血流动力学指标水平，比较两组患者镇痛和镇静评分，记录两组患者不良反应和并发症发生情况。

结果：对照组T₁、T₂、T₃、T₄时间点心率(HR)、舒张压(diastolic blood pressure，DBP)、收缩压(systolic blood pressure，SBP)较T₀时间点呈现不同程度升高(P<0.05)； 研究组T₁、T₂、T₃、T₄时间点HR、DBP、SBP较T₀时间点呈现不同程度下降(P<0.05)，且显著低于同时间对照组(P<0.05)。两组患者T₁、T₂、T₃、T₄时间点镇痛评分呈现不同程度下降，且研究组镇痛评分显著低于同时间对照组(P<0.05)； 对照组T₁、T₂、T₃、T₄时间点镇静评分较T₀时间点呈现不同程度下降(P<0.05)，研究组T₁、T₂、T₃、T₄时间点镇静评分较T₀时间点呈现不同程度升高，但差异无统计学意义(P>0.05)，且显著高于同时间对照组(P<0.05)。研究组不良反应和并发症发生率显著低于对照组(P<0.05)。

结论：应用盐酸右美托咪定在老年白内障合并高血压患者手术中行监护麻醉，能够稳定血流动力学，具有明显镇痛镇静效果。

METHODS: Totally 90 senile patients with hypertension receiving cataract surgery were randomly divided into two groups, 45 cases in study group during the surgery by intravenous infusion of dexmedetomidine hydrochloride, 45 cases in control group were given normal saline for intravenous infusion. Blood flow dynamics index level were detected in two groups at five time points of before surgery(T₀), beginning of the surgery(T₁), 10 min after beginning(T₂), 20 min after beginning(T₃), the end of surgery(T₄). Analgesia and sedation scores were compared in two groups, the incidence of adverse reactions and complications were recorded in two groups.

RESULTS: Heart rate(HR), diastolic blood pressure(DBP), systolic blood pressure(SBP)increased significantly at the time points of T₁, T₂, T₃, T₄ compared with T₀ time point in the control group(P<0.05). HR, DBP, SBP decreased significantly at the time points of T₁, T₂, T₃, T₄ compared with T₀ time point in the study group(P<0.05), which of the study group were significantly lower than the control group at the same time(P<0.05). Analgesia scores at the time points of T₁, T₂, T₃, T₄ were showed different degrees of decline in the two groups, and analgesia scores in the study group were significantly lower than that of the control group at the same time(P<0.05). Sedation scores at the time points of T₁, T₂, T₃, T₄ were showed different degrees of decline compared with T₀ time point in the control group(P<0.05). Sedation scores at the time points of T₁, T₂, T₃, T₄ were showed different degrees of rise compared with T₀ time point in the study group(P>0.05). Sedation scores in the study group were significantly higher than that of the control group at the same time(P<0.05). The incidence of adverse reactions and complications in the study group was significantly lower than that of the control group(P<0.05).

CONCLUSION: Application of dexmedetomidine hydrochloride to monitoring anesthesia during senile cataract patients with hypertension surgery, can stabilize the hemodynamics and has obvious sedation and analgesia effect.