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Right dexmedetomidine sedation observed in the clinical efficacy of neurosurgery

Author: Anonymous From: www.yourpaper.net Posted: 2010-06-24 10:24:13 Read:
: Yang Qingxiao off civilization, Yan Shijun
[Abstract] Objective To observe the right dexmedetomidine (of dexmedetomidine, DEX) drug sedation clinical efficacy. Methods of Neurosurgery, restlessness or after general anesthesia 30 patients, the first application of a loading dose of 10min, and then apply the maintenance dose continuous intravenous injection. Dextromethorphan care microphone pyridine sedative effect more obvious, and lower heart rate, markedly effective in 26 cases, 4 cases, five cases after the sedation heart rate decreased, down to 60 beats / min, but in the reduction remission. No inhibition of respiratory adverse reactions. Conclusions right dexmedetomidine with a sedative, also lowering heart rate, adverse reactions, one of the better drugs for treatment of Neurosurgery, restlessness or general anesthesia patients with postoperative agitation.
[keyword] adrenergic alpha agonist; neurosurgery; sedation; clinical efficacy
Intracranial lesions caused by restless patients is clinically more common. Such patients if given a positive control, will increase the suffering of patients, worse, increased cerebral edema, increased incidence of complications, and reduce the quality of life of patients with brain lesions and recovery effect, even life-threatening. Right of dexmedetomidine (Aibei Ning) sedative effect is remarkable, and lower heart rate, are as follows.
Materials and Methods
1.1 Case Selection November 2009 - January 2010 Neurosurgery, Second Hospital of Jilin University, intracranial lesions cause restlessness or general anesthesia endotracheal intubation and mechanical ventilation the cases of 30 cases. 18 males and 12 females; aged 25 to 65 years of age; course of 7 to 15 days. The most common symptoms of traumatic brain injury caused by restlessness.
1.2 treatment are shown in Table 1. Table 1 hydrochloric right dexmedetomidine scale Note: 2ml: 200g of this product with 48ml 0.9% of sodium chloride solution mixed prior to administration must diluted concentration 4ug/ml; loading dose and maintenance dose, use concentration of 4ug/ml. (1) adult loading dose: to concentration of 1g/kg dose 4ug/ml, micro pump slow intravenous injection over 10min; (2) maintenance dose: continuous intravenous infusion rate of 0.2 to 0.7g / (kg - h)
treatment effects
2.1 The effect of the standard indicator of the depth of sedation (such as: clinical presentation, sound, pain and surgical stimuli qualitative indicators), effective: stable than before, with stable vital signs, a simple exchange. : Stable vital signs were stable compared with the previous sentiment, calling eyes. Invalid: restlessness, no significant improvement over the previous.
2.2 Results efficacy and degree of agitation in patients with significant sedation, restlessness, the more serious the sedative drug effect is more obvious, to be added to achieve the desired effect. During the treatment, the patient sedation decrease in heart rate returned to normal, but by the reduction or withdrawal, no significant adverse reactions. Three cases of patients with restless invalid, 5 patients with heart rate slowed down. discussion
Right Dexmedetomidine is a selective alpha 2 adrenergic receptor antagonist with anti-sympathetic, sedative and analgesic effects, right dexmedetomidine role in two adrenaline receptor, through activation of presynaptic membrane alpha2 receptors, inhibit the release of norepinephrine, and to terminate the conduction of pain signals; through activation of postsynaptic receptors, right dexmedetomidine inhibit the sympathetic activity causing a decline in blood pressure and heart rate. In addition, the use of the drug in patients with easy awakening. Adverse effects including hypotension, hypertension, and bradycardia. DEX dose-dependent sedative, anxiolytic and analgesic effect, and no respiratory depression [1], studies suggest that DEX can reduce the amount of anesthetic and anti-sympathetic role of hemodynamic stability, at the same time, it is the only way to wake sedative [2]. Right dexmedetomidine can generate a wake-up sedation, "to be natural sleep" function.
Right dexmedetomidine sedation as a NICU, analgesics, has been proven to reduce other sedatives and analgesics requirement to maintain hemodynamic stability and respiratory function, easily wake neurological examination, exchange with the doctor [3]. DEX has anti-nociceptive, reduce the amount of anesthetic, and enhance the role of perioperative cardiovascular stability is the only easy to wake up cooperation sedatives without respiratory depression, can reduce cerebral blood flow, increased intracranial pressure, improve anesthesia recovery process [4].
The hospital neurosurgery hospital restless patients after general anesthesia in patients with hydrochloric acid right of dexmedetomidine use of scale sedation, observed in patients with restless, hydrochloric right dexmedetomidine scale sedation 1 to 3 days after the symptoms of mild agitation basic can be alleviated; moderate to severe restlessness, increased dosage and extension of treatment time, and with the duration of treatment, the number of cases the symptoms also increased. Summary, right dexmedetomidine after all, a treatment of neurosurgical restlessness or general anesthesia one of the better drugs for patients with postoperative agitation Select.
[References]
1 Penttila J, Helminen A, Anttila M, et al. Cardiovascular and parasympatheticeffects of dexmetomidine in healthy subjects. Canadian Jphysiology and pharmacology, 2004, 82: 359-362.

2 Yildiz M, Tavlan A, Tuncer S, et al. Effect of dexmedetomidine on haemodynamics and anesthetic requirements. Drugs RD, 2006, 7 (1): 43 - 52.

3 Venn RM, Grounds RM. Comparison between dexmedetomidine and propofol for sedation in the intensive care unit: patient and clinician perceptions. Br J Anesth, 2001, 87: 684-690.

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