Dexmedetomidine Sedation In Postoperative Patients With Hypertensive Intracerebral Hemorrhage

Experimental Purpose:To observe the effects of dexmedetomidine sedation therapy for theacute stage of patients with hypertensive cerebral hemorrhage on breath,heart rate, mean arterial pressure, oxygen saturation, GCS score,rehaemorrhagia in postoperative.Experimental methods:Select53cases in Department of Neurosurgery, Second Hospital ofJilin University, operation treatment of hypertensive cerebral hemorrhagepatients from January2012to December2012, randomly divided intosedative group and conventional group.29patients in sedative group,male22cases, female7cases, average age is58.2years old.24patientsin conventional group, male19cases, female5cases, average age is57.9years old. The two groups were given hemostasis, lowering theintracranial pressure, acid suppression, nerve nutrition and maintain waterelectrolyte balance therapy. Furdermore,the sedation group receiveddexmedetomidine sedation therapy, the dose which patients achievedRamsay score II-IV was maintenance dose. The two groups wereobserved and compared after operation, heart rate, respiration, meanarterial pressure, blood oxygen saturation, GCS score，rehaemorrhagia.Because the drug has not been completely metabolism after anesthesia,will have an impact on the observed indexes, so starting monitoring from4hours postoperative to24hours, every2hours to monitor once. After 24hours,3days after the head of CT, determine the rehaemorrhagia(hematoma volume exceeded the20ml, midline shift more than1cm).Results:Sedation group and the conventional group heart rate were85.6±14.7/min,89.4±14.1beats per minute, respiratory was18.8±3.2/min,20.7±3.5/min, mean arterial pressure was97.8±8.4mmHg,101±9.2mmHg, results showed that there were significant differences. Sedationgroup and conventional group respiratory rate were20.7±3.5/min，8.8±3.2/min, blood oxygen saturation were97.3±1.6%and97.2±1.8%,reduces the respiratory frequency resulted in stress and other reasons toincrease quickly, no influence on blood saturation. According topostoperative GCS score of two groups were6.1±2.5and6.3±2, nosignificant difference between the two. Sedation group rehaemorrhagiawas1cases, control group rehaemorrhagia was3cases, no significantdifference between two groups, but the sedation group rehaemorrhagiaratio declined.Conclusions:11. Dexmedetomidine can improve the acute period of postoperativeblood pressure, respiration, heart rate instability.2. Dexmedetomidine make under sedation without influence on thestate of consciousness that identify patients, conscious sedation.3.Dexmedetomidine has no inhibition of respiration.