Department 5 of Neurosurgery, Cangzhou Central Hospital, Cangzhou, Hebei, China.
Department of Nursing, CangZhou Medical College, Cangzhou, Hebei, China.
World Neurosurg. 2022 Dec;168:e570-e577. doi: 10.1016/j.wneu.2022.10.041. Epub 2022 Oct 14.
Intracranial aneurysm (IA) has been identified in approximately 0.4%-3% of the population and associated with 3%-10% mortality. IA is the major factor attributing to spontaneous subarachnoid hemorrhage. We aim to investigate that whether employing dexmedetomidine (DEX), an α2 adrenergic receptor agonist, as a supplementation could impact the outcomes of patients with intracranial interventional embolization.
Patients were randomly divided into a control group (n = 48 cases) and a DEX (0.6 μg/kg) supplement group (n = 48 cases). Patients' outcomes were evaluated using the Glasgow Outcome Scale. Serum levels of norepinephrine, cortisol, interleukin-6, C-reactive protein, neuron-specific enolase, and S100β were determined using enzyme-linked immunoassay. The cognitive function of patients was assessed using the Mini-Mental State Exam and Montreal Cognitive Assessment tests.
DEX supplementation during anesthesia reduced adverse reaction, surgical stress, and attenuated cognitive impairment after extubation in IA patients' postintracranial interventional embolization.
Our study demonstrated that employing DEX as supplementation during anesthesia could effectively reduce surgical stress and improve cognitive function, ultimately improving patients' recovery from intracranial interventional embolization.
颅内动脉瘤（IA）在人群中的发病率约为 0.4%-3%，并与 3%-10%的死亡率相关。IA 是导致自发性蛛网膜下腔出血的主要因素。我们旨在研究α2 肾上腺素能受体激动剂右美托咪定（DEX）作为辅助药物是否会影响颅内介入栓塞患者的预后。
患者被随机分为对照组（n=48 例）和 DEX（0.6μg/kg）补充组（n=48 例）。采用格拉斯哥预后量表评估患者的预后。采用酶联免疫吸附试验测定血清去甲肾上腺素、皮质醇、白细胞介素-6、C 反应蛋白、神经元特异性烯醇化酶和 S100β的水平。采用简易精神状态检查和蒙特利尔认知评估测试评估患者的认知功能。
麻醉中给予 DEX 补充可减轻颅内介入栓塞后患者的不良反应、手术应激反应，并减轻拔管后认知障碍。
我们的研究表明，在麻醉中使用 DEX 作为辅助药物可以有效减轻手术应激反应，改善认知功能，最终改善颅内介入栓塞患者的康复。
