The Application Of Dexmedetomidine In Neurosurgical Patients Undergoing DSA Examination

Objective:Digital Subtraction Angiography can clearly show theinternal carotid artery, vertebral basilar artery, intracranial large vesselsand vascular images hemisphere, also measured arterial blood flow,cerebral vascular disease has now been applied to the examination,especially for aneurysm, arteriovenous malformations and otherqualitative diagnosis, it is the best diagnostic tool. Some patients fear orirritability in patients with severe traumatic brain injury, with theinspection process is not difficult, and cause psychological discomfort ofthe patient and the physical.This paper aims to study the application givendexmedetomidine hydrochloride in DSA examination of patients withappropriate sedation, so patients with nervous fear of elimination, theinspection process patients more comfortable, so restless patients cancooperate with the inspection, the inspection process to shorten therequired time and improve accuracy, provide more efficient and accuratebasis for the diagnosis of the patient’s condition.Methods:Choose60patients need to line DSA examinations ofNeurosurgery, Second Hospital of Jilin University, August2013-2013in December.A randomized double-blind method is divided intoA: DEXdexmedetomidine,B: midazolam, C: matched group.There are20patientsin each group.Three groups of patients were no significant differences ingender, age, body weight.A selected group of patients given dexmedetomidine given a loading dose1μg/kg, the loading dose infusion time is set to15minutes.After the loadis complete, then0.1-0.7μg/kg/h maintain.At the end of surgery10minutes before stopping.Group B patients enrolled after intravenous midazolam group first given0.05mg/kg loading dose of midazolam, the injection time of1min, andthen0.02~0.1mg/kg h speed/maintenance in elderly patients due tolower consumption.10minutes before the end of surgery withdrawal.Group C was selected into the cath lab patients after intravenous saline5ml.Results: Three patients were T0-T2periods MAP no significantdifference. The control group was significantly higher MAP start from T3,T5checks continued to the end. Given dexmedetomidine and midazolamgroup was no significant increase in MAP, given dexmedetomidine groupthan the midazolam group of smaller fluctuations MAP.Third group of patients HR T0no difference, T1-T4group HR continuesto rise, to T5slight downward trend, but increased significantly comparedwith T0. Given dexmedetomidine and midazolam group heart rate did not change significantly, no significant differences between the twoexperimental groups.Ramsay score differences among the three groups was not statisticallysignificant at T0, T1-T5when in significant differences, and givendexmedetomidine and midazolam sedation group scores weresignificantly higher. T2, T5when dexmedetomidine group set slightlyhigher than the midazolam group,P <0.05.T0VAS score differences among the three groups when the group wasnot statistically significant, but when the difference in T1-T5significant,and two experimental groups pain scores were significantly lower thanthe control group. T3when given dexmedetomidine group than in the lowalprazolam midazolam group, P=0.047.Control group had no respiratory depression, no difference in the threegroups at T0, T1-T4both the experimental and control groups weresignificant, P <0.01. T5when there is no difference, P>0.05. T1-T3whenmidazolam group set slightly higher than the dexmedetomidine group.Control group cooperation is relatively poor.Adverse reactions, the control group, a higher incidence of hypertensionand tachycardia, P <0.01. No significant differences in other areas.Conclusion:Can play when given dexmedetomidine and midazolam used in neurosurgical patients with DSA, good sedation, fewer adverse reactions,and compared with midazolam, dexmedetomidine has some analgesicgiven effects, mild respiratory suppression, more stable hemodynamics.