The protective and hemodynamic effects of dexmedetomidine on hypertensive cerebral hemorrhage patients in the perioperative period

The aim of the present study was to analyze the protective and hemodynamic effects of dexmedetomidine in hypertensive cerebral hemorrhage (HCH) patients during perioperative period. In total, 50 HCH patients were selected and randomly divided into two groups, one group was administered with dexmedetomidine and the other groups with midazolam. The mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO(2)) were monitored in the two groups of patients before and during the operation. The MAP, HR, SpO(2) and P(ET)CO(2) recorded 5 min after admission into the operation room was considered T(1), the same parameters recorded 10 min after drug administration were considered T(2), just after starting the operation were considered T(3) and 30 min after start of operation were considered T(4). The preoperative sedation and analgesia were evaluated by the Ramsay scoring method and the neuron-specific enolase (NSE) and S100 protein (S100β) were estimated using ELISA. The patients of the midazolam group experienced mild respiratory depression during the period of sedation. Levels of, MAP, HR and P(ET)CO(2) were significantly increased whereas SPO(2) was decreased (P<0.05). The MAP, HR, SPO(2) and P(ET)CO(2) were stable during the period of sedation (P>0.05). The plasma concentrations of epinephrine and norepinephrine at T(1) were similar in the two groups (P>0.05), but decreased after drug administration. This decrease was more prominent in the dexmedetomidine group patients (P<0.05) than midazolam group patients. The epinephrine and norepinephrine concentrations just after starting operation (T(3)) were higher than the basal level (T(1)) in the midazolam group, but close to the basal level in the dexmedetomidine group (P<0.05). The serum concentration of NSE and S100β in the two groups showed no difference (P>0.05) at the end of operation (T(5)), but after 24 h of operation (T(7)) NSE and S100β in the dexmedetomidine group were significantly lower compared to the midazolam group (P<0.05). In conclusion, the administration of dexmedetomidine for patients with HCH during perioperative period is safe and serves as an effective sedative, without causing respiratory depression and does not influence stable haemodynamics with certain brain protective effect.