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To observe the clinical efficacy and safety of dexmedetomidine injection combined with remifentanil injection and scalp nerve block in patients undergoing craniotomy for aneurysm clipping.
Patients who underwent craniotomy for aneurysm clipping were divided into control group and treatment group according to random number method . All patients were treated with a unified scheme for anesthesia induction, and ultrasound-guided scalp nerve block was performed after induction. During the anesthesia maintenance phase, remifentanil injection (0.1-0.2 μg·kg-1·min-1), atracurium besylate injection (0.2 mg·kg-1·h-1) and propofol emulsion injection (3-8 mg·kg-1·h-1) were continuously pumped into the two groups. And dexmedetomidine injection (0.4 μg·kg-1·min-1) was pumped into the treatment group on the basis of control group. The recovery time, extubation time, hemodynamic changes, analgesia and sedation scores, brain injury and emergency response related markers were compared between the two groups, and the safety was evaluated.
A total of 110 cases were enrolled, including 55 in control group and 55 in treatment group. The recovery time of control group and treatment group were (19.73±3.52) and (17.87±2.69) min, respectively; and the extubation time were (21.78±3.83) and (19.33±3.46) min, respectively; the mean arterial pressure (MAP) at 5 minutes after intubation (T1) were (83.67±12.99) and (89.31±14.39) mmHg, respectively; and at nerve block (T2), the MAP were (81.40±13.92) and (86.58±12.18) mmHg, respectively; at 10 minutes after the operation (T5), the MAP were (83.56±12.58) and (89.02±13.48) mmHg, respectively; and the heart rate (HR) at T1 were (65.55±11.39) and (72.42±11.66) beats·min-1, respectively; the HR at T2 were (63.65±13.54) and (70.15±12.29) beats·min-1, respectively; at 10 minutes after nerve block (T3), the HR were (64.65±14.26) and (71.13±12.49) beats·min-1, respectively; when sawing the skull (T4), the HR were (62.44±12.67) and (69.02±13.57) beats·min-1, respectively; and at T5, the HR were (67.18±10.40) and (74.84±13.77) beats·min-1, respectively. Compared with control group, the differences of the above indicators of treatment group were all statistically significant (all P<0.05). The total incidence of adverse drug reaction rates in control group and treatment group were 30.91% (17 cases /55 cases) and 14.55% (8 cases /55 cases), respectively, with statistically significant difference (P<0.05).
Dexmedetomidine injection combined with remifentanil injection and scalp nerve block has good clinical efficacy and safety in craniotomy and aneurysm clipping.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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