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Neuroprotective effect of bispectral index-guided fast-track anesthesia using sevoflurane combined with dexmedetomidine for intracranial aneurysm embolization

Neuroprotective effect of bispectral index-guided fast-track anesthesia using sevoflurane combined with dexmedetomidine for intracranial aneurysm embolization

作     者:Chao-liang Tang Juan Li Zhe-tao Zhang Bo Zhao Shu-dong Wang Hua-ming Zhang Si Shi Yang Zhang Zhong-yuan Xia 

作者机构:Department of Anesthesiology Renmin Hospital of Wuhan University Department of Anesthesiology Anhui Provincial Hospital of Anhui Medical University Department of Pharmacy Anhui Provincial Hospital of Anhui Medical University Department of Neurosurgery Anhui Provincial Hospital of Anhui Medical University 

出 版 物:《Neural Regeneration Research》 (中国神经再生研究(英文版))

年 卷 期:2018年第13卷第2期

页      面:280-288页

核心收录:

学科分类:0710[理学-生物学] 1002[医学-临床医学] 1001[医学-基础医学(可授医学、理学学位)] 10[医学] 100217[医学-麻醉学] 

基  金:supported by the National Natural Science Foundation of China No.81671891 

主  题:nerve regeneration dexmedetomidine sevoflurane bispectral index fast-track anesthesia embolization of intracranial aneurysm stress response neuroprotection neural regeneration 

摘      要:Dexmedetomidine has sedative, anxiolytic, analgesic, anti-sympathetic, and anti-shivering effects. Dexmedetomidine might be effective in combination with sevoflurane for anesthesia, but prospective randomized controlled clinical trials with which to verify this hypothesis are lacking. In total, 120 patients who underwent embolization of an intracranial aneurysm were recruited from Anhui Provincial Hospital and Renmin Hospital of Wuhan University of China and randomly allocated to two groups. After intraoperative administration of 2% to 3% sevoflurane inhalation, one group of patients received pump-controlled intravenous injection of 1.0 ~tg/kg dexmedetomidine for 15 minutes followed by maintenance with 0.3 ~tg/kg/h until the end of surgery; the other group of patients only underwent pump-controlled infusion of saline. Bispectral index monitoring revealed that dexmedetomidine-assisted anesthesia can shorten the recovery time of spon- taneous breathing, time to eye opening, and time to laryngeal mask removal. Before anesthetic induction and immediately after laryngeal mask airway removal, the glucose and lactate levels were low, the S100~ and neuron-specific enolase levels were low, the perioperative blood pressure and heart rate were stable, and postoperative delirium was minimal. These findings indicate that dexmedetomidine can effectively assist sevoflurane for anesthesia during surgical embolization of intracranial aneurysms, shorten the time to consciousness and extubation, reduce the stress response and energy metabolism, stabilize hemodynamic parameters, and reduce adverse reactions, thereby reducing the damage to the central nervous system. This trial was registered at the Chinese Clinical Trial Registry (http://***. cn/) (registration number: ChiCTR-IPR- 16008113).

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