The Cause Of Restlessness Patients With Craniocerebral Injury And The Study Of Sedation And Analgesia

Objective:To analyze the restlessness of craniocerebral trauma patients andoptimize the choice of sedative and anodyne.Methods:Between November11,2011and November11,2013,67craniocerebral patients in neurosurgery of Jilin University SecondHospital were studied by us,55male and12female. Aged15to71years,average39.3years. Firstly, find out the causes of restlessness accordingto the patients conditions and clinical manifestations. Secondly, clinicaltreatments based on different causes. for patients with clear cause, takeconventional processing, such as keep respiratory tract unobstructed,make the blood volume stability, the person with light consciousnesscould be treat with comfort bed words to disturb the causes of restless；Remove cause restlessness reversible after calm analgesic drugapplication, application right beauty’s microphones set injection200ug/(jiangsu hengrui,09061732), load1mu g/kg static push to completewithin10min, maintenance dose applied vein pump by0.2to0.7mug/kg/h of continuous intravenous infusion speed, and on the basis of restlessness and the level of sedation analgesia in patients with adjustdosage, analgesia pethidine injection can also be used when the effectnot beautiful. Will calm analgesic Riker calm restless score3to4points.Observe patients before and after the application right beauty’smicrophones set, heart rate, breathing, mean arterial pressure, arterialoxygen partial pressure, blood oxygen saturation, awakening andGlasgow score changes and medication before and after30min,1,2,6,12,24h detection of blood gas analysis.Results:Cause of restlessness can be roughly divided into the intracranialand extracranial factors, including intracranial factor44.78%,extracranial factor of55.22%. This group of67patients with restless,after restlessness reason clearly and in a timely manner to give positiveafter symptomatic treatment,55cases of patients are different degree ofrestlessness. More than55patients in mi constant load dose intravenouspush the right note after10minutes, Riker calm restless score of3or4points51cases of patients, the total effective rate was92.73%.Following an sedation analgesia in patients with mean arterial pressureby102.0+/-5.3mmHg fell to93.0+/-5.0mmHg, application after2h heart rate by101.2+/-10.7times/min to87.9+/-10.0times/min,breathing in the mi application right beauty set of26after2h.5+3.9times/min to22.4+/-3.1times/min, apply drugs after2h PaO2by 72.3+/-4.9mmHg at78.3+/-4.6mmHg, SpO2plus or minus2.9to90.3%from95.2%plus or minus1.9.Conclusion:1. The cause of restlessness in craniocerebral patients are complexed,including intracranial factors and extracranial factors.2. On the premise of fully dispel reversible inducement, restless patientsshould be treated to get sedate and antalgic as soon as possible.3. The Dexmedetomidine is the ideal drug to make sedation, cause mildanalgesia, stabilize the hemodynamics, and without respiratorydepression.