Neuroprotective effect of bispectral index-guided fast-track anesthesia using sevoflurane combined with dexmedetomidine for intracranial aneurysm embolization
| Autor: | Zhongyuan Xia, Juan Li, Bo Zhao, Hua-Ming Zhang, Yang Zhang, Shu-Dong Wang, Chaoliang Tang, Zhe-Tao Zhang, Si Shi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_treatment
sevoflurane Hemodynamics nerve regeneration dexmedetomidine bispectral index fast-track anesthesia embolization of intracranial aneurysm stress response neuroprotection neural regeneration Sevoflurane lcsh:RC346-429 03 medical and health sciences 0302 clinical medicine Developmental Neuroscience Laryngeal mask airway medicine 030212 general & internal medicine Embolization Dexmedetomidine Saline lcsh:Neurology. Diseases of the nervous system business.industry Perioperative Anesthesia Bispectral index business 030217 neurology & neurosurgery medicine.drug Research Article |
| Zdroj: | Neural Regeneration Research, Vol 13, Iss 2, Pp 280-288 (2018) Neural Regeneration Research |
| ISSN: | 1673-5374 |
| Popis: | 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 μg/kg dexmedetomidine for 15 minutes followed by maintenance with 0.3 μg/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 spontaneous 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 S100β 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://www.chictr.org.cn/) (registration number: ChiCTR-IPR-16008113). |
| Databáze: | OpenAIRE |
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