摘要
Abstract
Objective To investigate the clinical effect of dexmedetomidine on restlessness and sedation in patients with severe traumatic brain injury and the effect of anesthesia on brain protection.Methods 50 patients with severe craniocerebral trauma in the First People's Hospital of Zhumadian were selected from December 2014 to December 2016 as the experimental group and all treated with surgery,1.0 ug/kg intravenous injection of dexmedetomidine was given before routine anesthesia induction,and then 0.5 μg/(kg · h) was maintained until the end of operation.Another 50 patients in the same period were selected as the control group and treated with 0.1 mg/kg intravenous infusion of midazolam before induction of anesthesia,and then 30 μg/(kg · h) is maintained until the end of the operation.Sedation status was assessed within 24 hours by using the Ramsay sedation score.Serum S-100-beta protein and neuron specific enolase (NSE) levels were measured by using enzyme linked immunosorbent assay (ELISA) before and after surgery,respectively at 24h after operation.Cerebral oxygen uptake rate (CERO2),internal carotid arterial-venous oxygen content difference (Da-jvO2) and jugular venous oxygen saturation (SjvO2) were also detected.Results The scores of 12h-and 24h-Ramsay in the experimental group were (3.2±0.6) points,(2.5±0.6) points;and the control group were (3.9±0.7) points,(3.1±-0.6) points,respectively.The sedative effect of the experimental group was better than that of the control group at different time points (P＜0.05).Two groups of patients had simialr S-100,NSE,CERO2 protein and Da-jvO2 and SjvO2 levels before operation (P＞ 0.05).The levels of S-100,beta protein,NSE,CERO2 and SjvO 2 in the two groups were increased (P＜0.05) after 24h,but the experiment group had lower S-100,NSE,CERO2 protein,Da-jvO2 levels and higher SjvO2 level than the control group (P＜0.05).Conclusion Dexmedetomidine can improve the sedative effect and improve the cerebral oxygen metabolism in patients with severe traumatic brain injury,all of which have a certain protective effect on brain.关键词
颅脑损伤/右美托咪啶/镇静/脑保护Key words
Dexmedetomidine/Craniocerebral injury/Calmness/Brain protection分类
医药卫生
