Dexmedetomidine combined with remifentanil used for sedation and analgesia in ICU patients with hypertensive cerebral hemorrhage

Abstract

Objective To explore the administration of Dexmedetomidine combined with remifentanil for sedation and analgesia of ICU patients with hypertensive cerebral hemorrhage after operation. Methods A total of 60 patients with hypertensive cerebral hemorrhage treated with hematoma removal under craniotomy were selected from May 2013 to June 2015. The patients were randomly (random number) divided into the Dexmedetomidine combined with remifentanil group (D +R, n=30) , and Midazolam combined with remifentanil group (M +R, n=30). The blood pressure, respiration rate, oxygen saturation, heart rate, ICP (intracranial pressure) , Ramsay sedation scores, and IL-1, and TNF-α levels were recorded after sedation and analgesia in ICU, and 6 h, 24 h, 48 h after operation (T0-T3). Results Compared with M +R group, the MAP, RR, HR, ICP, IL-1β, TNF-α, rate of reoperation for check bleeding, and mortality were significantly decreased in D +R group (P <0.05) , and Ramsay sedation score was significantly increased at the same time (P <0.05) without excessive sedation and analgesia noticed. Conclusions Dexmedetomidine combined with remifentanil exhibits significant benefit in many respects including control of great fluctuations of blood pressure and intracranial pressure after craniotomy, reduce the production and release of inflammatory mediators, reduce the occurrence of rebleeding after operation. It shows good controllability and safety, it is an optimal method producing sedation and analgesia in ICU patients with hypertensive cerebral hemorrhage after operation. Key words: ICU; Dexmedetomidine; Remifentanil; Hypertensive cerebral hemorrhage after operation; Rebleeding; Cerebral protection; Sedation; Analgesia