Abstract: Objective To explore the application effect of Ketamine+Dexmedetomidine+Nicardipine in the anesthesia of hip Joint replacement for elderly patients with hypertension. Methods 80 elderly patients with hypertension undergoing hip replacement surgery admitted to Yanqi Hospital of the Second Division of Xinjiang Production and Construction Corps from June 2021 to May 2023 were selected for research and analysis.They were divided into control group (n=30), observation group A (n=25), and observation group B (n=25) based on different anesthesia methods. All patients underwent routine general anesthesia induction, while the control group received nicardipine continuous intravenous infusion of 0.5 μg/kg • min before induction, observe group A using nicardipine continuous intravenous infusion of 0.5 μg/kg • min and 0.5 μg/kg dexmedetomidine intravenously pumped for 10 minutes before induction, followed by maintenance of continuously pump at a speed of 0.4 μg/kg • h, observe Group B, in observation group B, in addition to the measures taken in observation group A, 0.35mg/kg of Ketamine was added during induction, and maintained at a rate of 0.3~0.4mg/kg · h. Compare the changes in blood oxygen saturation (SPO₂), systolic blood pressure (SBP),diastolic blood pressure (DBP), heart rate (HR) of three groups of patients at entry (T₁), immediately after surgery (T₂), 20 minutes after surgery (T₃),and immediately after surgery (T₄).Compare the intraoperative propofol dosage,intraoperative remifentanil dosage, surgery time, intraoperative bleeding volume, and postoperative recovery time, and finally compare the incidence of adverse reactions. Results There was no significant difference in SPO2 among the three groups of patients at T₁, T₂, T₃, and T₄ time. There was no significant difference in HR, DBP, and SBP among the three groups of patients at T₁ and T₄ time (P>0.05). HR, DBP, and SBP in Group B were lower than those in Group A and the control group at T₂ and T3 time (P<0.05); There was no significant difference in surgical time and postoperative recovery time among the three groups of patients (P>0.05). There was no significant difference in surgical time, intraoperative bleeding volume, and postoperative recovery time among the three groups of patients (P>0.05).The intraoperative dosage of propofol and remifentanil in Group B was significantly lower than that in the control group and Observation Group A (P<0.05); The statistical results of adverse reactions showed that compared to the observation of Group A and the control group, there were fewer observations of Group B (P<0.05). Conclusion For elderly hypertensive patients undergoing hip arthroplasty, using ketamine, dexmedetomidine, and nicardipine as an auxiliary general anesthesia can stabilize the patient's intraoperative vital signs, reduce the amount of anesthesia required during the surgery, and reduce the incidence of adverse reactions to anesthesia.

Key words: espex ketamine, dexmetomidine, nicardipine, hypertension, joint replacement, vital signs