Abstract:

 AIM: To investigate the effects of dexmedetomidine, hydroxyethyl starch combined with fentanyl on brain glucose and oxygen metabolism in elderly patients with hypertensive cerebral hemorrhage after emergency surgery. METHODS: A total of 120 patients undergoing the minimally invasive aspiration of hypertensive cerebral hemorrhage with routine treatment methods in our hospital from October 2015 to May 2017 were selected, and were divided into observation group and control group according to random principle, each of 60 cases. The observation group was given dexmedetomidine, hydroxyethyl starch combined with fentanyl in anesthesia, and the control group was treated with propofol combined with fentanyl. Hemodynamics index (MAP, SBP, DBP ) were compared between the two groups; the cognitive function of the two groups was compared by MMSE (Mini-Mental state examination) before anesthesia and postoperative 1, 3 and 5days; sugar metabolism of oxygen monitoring indicators (SjvO₂, CEO₂, and A-VGlu, AVDO₂, A-VPCO₂ and A-VLac) in the two groups were monitored and compared. RESULTS: (1) During the operation and postoperative 24 hours, the heart rate, MAP, SBP and DBP of control group changed significantly (P<0.05), the observation group did not change significantly (P＞0.05), the observation group T2, T3 time heart rate, T2 time MAP, SBP and SBP were significantly better than the control group (P<0.05); (2)The MMSE score of the two groups after 1 days and 3 days, the observation group were significantly higher than those in control group (P<0.05); (3)Oxygen glucose metabolism index of the patients in the observation group (SjvO2, CEO2, A-VGlu, AVDO2, AVPCO2 and A-VLac) was significantly better than the control group (P<0.05). CONCLUSION: Anesthesia application of dexmedetomidine, hydroxyethyl starch combined with fentanyl in patients with hypertensive cerebral hemorrhage in conclusion, stable hemodynamics during operation and postoperative respiratory depression and postoperative cognitive dysfunction in low level.

Key words: dexmedetomidine, hydroxyethyl starch, fentanyl, hypertensive cerebral hemorrhage, cerebral oxygen and glucose metabolism