Department of Anesthesiology, Cangzhou Central Hospital, No. 16 Xinhua Western Road, Cangzhou, Hebei Province, P.R. China.
Purchasing Department, Cangzhou Central Hospital, No. 16 Xinhua Western Road, Cangzhou, Hebei Province, P.R. China.
J Int Med Res. 2021 Dec;49(12):3000605211062789. doi: 10.1177/03000605211062789.
To explore the effects of sedation and analgesia with dexmedetomidine and other drugs on the stress response in patients with cerebral hemorrhage after craniotomy hematoma removal and bone flap decompression and insertion of an indwelling endotracheal catheter.
A total of 180 patients with cerebral hemorrhage with consciousness disturbance who underwent emergency surgery were included in this study. They were divided into six groups treated with propofol, dexmedetomidine, lidocaine, sufentanil, dezocine, and remifentanil, respectively. Intravenous medication was given after recovery of spontaneous respiration, and stress responses were compared among the group.
Serum concentrations of norepinephrine, epinephrine, and cortisol and systolic blood pressure were significantly correlated with drug treatment. Serum norepinephrine concentrations differed significantly among the groups, except between the sufentanil and propofol groups. There were significant differences in serum epinephrine concentrations among all groups, and significant differences in serum cortisol concentrations among all groups, except the propofol, dexmedetomidine, and lidocaine groups.
Dexmedetomidine can reduce the stress response in patients with intracerebral hemorrhage undergoing emergency craniotomy and bone flap decompression, and can reduce adverse events from an indwelling endotracheal catheter 3 hours post-operation.
探讨右美托咪定与其他药物镇静镇痛对脑出血患者开颅血肿清除去骨瓣减压术后留置气管插管应激反应的影响。
选择 180 例伴有意识障碍的脑出血患者，均行急诊手术，将其分为六组，分别采用丙泊酚、右美托咪定、利多卡因、舒芬太尼、地佐辛、瑞芬太尼进行治疗，待患者恢复自主呼吸后给予静脉给药，并比较各组的应激反应。
血清去甲肾上腺素、肾上腺素和皮质醇浓度与血压呈正相关，且与药物治疗有显著相关性。除舒芬太尼与丙泊酚组外，各组间血清去甲肾上腺素浓度差异均有统计学意义。各组间血清肾上腺素浓度差异均有统计学意义，除丙泊酚、右美托咪定、利多卡因组外，各组间血清皮质醇浓度差异均有统计学意义。
右美托咪定可降低行急诊开颅去骨瓣减压术的脑出血患者的应激反应，减少术后 3 小时留置气管插管的不良反应。
