Effects of Dex in anesthesia on stress response and brain metabolism and function in elderly patients with hypertensive cerebral hemorrhage
10.3969/j.issn.1009-0126.2025.06.020
- VernacularTitle:老年高血压脑出血患者应用右美托咪定麻醉对应激反应和脑代谢及脑功能的影响
- Author:
Yifan AN
1
;
Hui QIAO
;
Shuting LIANG
;
Xiao WANG
;
Beibei MAO
;
Pengfei LIU
Author Information
1. 100038 首都医科大学附属北京世纪坛医院麻醉科
- Publication Type:Journal Article
- Keywords:
cerebral hemorrhage;
hypertension;
dexmedetomidine;
anesthesia;
stress,physiological
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2025;27(6):783-787
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine the effects of dexmedetomidine(Dex)in anesthesia on brain function,cerebral oxygen uptake rate(CERO2),difference in glucose content between cerebral ar-terial and venous blood(A-VDG)and jugular bulb oxygen saturation(SjvO2)and stress response in elderly patients with hypertensive cerebral hemorrhage.Methods A total of 96 elderly patients with hypertensive cerebral hemorrhage admitted to our hospital from January 2021 to June 2024 were recruited,and according to different anesthesia schemes,they were divided into the group A(propofol,remifentanil,sevoflurane combined with rocuronium anesthesia,48 cases)and group B(same anesthesia regimen as group A plus Dex).Glasgow coma(GCS)score and restlessness-sedation score 48 h after operation,postoperative recovery,stress indexes and cerebral glucose and oxygen metabolism before(T1)and at the end of operation(T2),and adverse reactions during the study were compared between the two groups.Results When compared with the group A,the group B had significantly higher GCS score 48 after surgery(13.95±0.28 vs 12.89±0.41,P＜0.01),and shorter awakening time,time to regain spontaneous breathing,extubation time and response time(P＜0.01).At T2,the levels of CERO2,A-VDG and SjvO2 were notably higher,while levels of cortisol,norepinephrine and epinephrine,and activity of renin were remarkably lower in the group B than the group A(P＜0.01).At T2,the both groups obtained increased levels of cortisol,norepinephrine,epinephrine and renin activity and SjvO2,while decreased CERO2 and A-VDG levels than the corresponding levels at T1(P＜0.05).The incidences of nausea and vomiting,cough,chills,restlessness and delirium was obviously lower in the group B than the group A(P＜0.05,P＜0.01).Conclusion For elderly patients with hypertensive cerebral hemorrhage,application of Dex in anesthesia can improve cerebral glucose and oxygen metabo-lism,reduce stress response,maintain the stability of perioperative vital signs,decrease the severi-ty of coma and incidences of delirium,nausea and vomiting,cough,chills,restlessness and other adverse reactions,and thus promote postoperative recovery.
