右旋美托咪定在轻中度颅脑损伤术后患者中的镇静效果及对颅内压的影响

doi:10.3969/j.issn.2095-378X.2023.03.009

Abstract

Abstract: Objective To explore the sedative effect of dexmedetomidine on patients with mild to moderate traumatic brain injury after operation and on intracranial pressure （ICP）. Methods A total of 180 patients with mild to moderate traumatic brain injury meeting designed inclusion criteria were enrolled as study subjects, and were divided into group A （dexmedetomidine）, group B （dexmedetomidine + propofol）, and group C （midazolam） by the random number table method. The Richmond Agitation Sedation Scale （RASS） score, ICP, changes of cerebral perfusion pressure （CPP）, and occurrence of hypotension and bradycardia were recorded before surgery （T1）, 1 h （T2）, 2 h （T3）, 6 h （T4）, 12 h （T5）, and 24 h （T6） after surgery. Results The RASS scores and Critical-care Pain Observation Tool （CPOT） scores of group A, group B, and group C at T1-T3 were not significantly different （P>0.05）. The RASS score and CPOT scores of group A and group B at T4-T6 were significantly lower than those of group C （P>0.05）. The proportions of optimal sedation （RASS score at -2 to +1） of group A and group B at T4-T6 were significantly higher than that of group C （P>0.05）, the proportions of over sedation （RASS score < -2） of group B at the same time points were higher than those of group A （P>0.05）, and the proportions of agitation （RASS score > +1） of group C at the same time points were higher than those of group A and group B （P>0.05）. The ICP values of group A and group B at T3-T5 were significantly lower than the values of group C （P>0.05）, and no difference in the lCP values were found between group A and group B at all time points. There was no difference in CPP at all time points （P=0.06） and the incidence rates of hypotension and bradycardia （P=0.15） among the three groups. Conclusion Dexmedetomidine produces a safe and reliable sedative effect on patients with mild to moderate traumatic brain injury after operation, and tends to achieve optimal sedation （RASS score at -2 to +1）.

Key words: Brain injury, Sedation, Dexmedetomidine, Propofol, Midazolam

CLC Number:

R614.2

XING Chunfeng, LUO Weixiang, ZHOU Yuehui, FANG Yuanyuan. Effect of dexmedetomidine on sedation and intracranial hypertension of patients with mild to moderate traumatic brain injury after operation[J]. Surgical Research and New Technique, 2023, 12(3): 192-196.

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Effect of dexmedetomidine on sedation and intracranial hypertension of patients with mild to moderate traumatic brain injury after operation

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