Effects of different sedatives/analgesics on stress responses in patients undergoing craniotomy and bone flap decompression

Abstract

Objective To explore the effects of sedation and analgesia with dexmedetomidine and other drugs on the stress response in patients with cerebral hemorrhage after craniotomy hematoma removal and bone flap decompression and insertion of an indwelling endotracheal catheter. Methods A total of 180 patients with cerebral hemorrhage with consciousness disturbance who underwent emergency surgery were included in this study. They were divided into six groups treated with propofol, dexmedetomidine, lidocaine, sufentanil, dezocine, and remifentanil, respectively. Intravenous medication was given after recovery of spontaneous respiration, and stress responses were compared among the group. Results Serum concentrations of norepinephrine, epinephrine, and cortisol and systolic blood pressure were significantly correlated with drug treatment. Serum norepinephrine concentrations differed significantly among the groups, except between the sufentanil and propofol groups. There were significant differences in serum epinephrine concentrations among all groups, and significant differences in serum cortisol concentrations among all groups, except the propofol, dexmedetomidine, and lidocaine groups. Conclusion Dexmedetomidine can reduce the stress response in patients with intracerebral hemorrhage undergoing emergency craniotomy and bone flap decompression, and can reduce adverse events from an indwelling endotracheal catheter 3 hours post-operation.

Effect of integrated perioperative rehabilitation intervention under the fast-track surgery concept on stress and complications in patients undergoing craniocerebral injury surgery

“…The results showed that after the intervention, the levels of HR, MAP, CORT, GLU, and E were significantly better in the postoperative FTS group than in the general group, indicating that the integrated perioperative rehabilitation intervention under the FTS concept was effective in relieving patients' stress reactions. Studies (21,22) have shown that E and CORT are sensitive indicators of the body's stress response, and that integrated perioperative Comparison of hemodynamic indexes and stress hormone levels between the two groups before and after the intervention. In the figure, 1 represents before intervention and 2 represents after intervention.…”

Perbandingan Kadar Interleukin-6 antara Pemberian Kombinasi Fentanil dan Midazolam Kontinyu dengan Deksmedetomidin Kontinyu pada Pasien Pascaoperasi Kraniotomi di Ruang ICU

“…Kraniotomi dapat dilakukan secara infratentorial ataupun supratentorial atau kombinasinya, dimana tindakan dilakukan di rumah sakit yang memiliki fasilitas bedah saraf dan Intensive Care Unit (ICU). 2,3 Dalam kondisi fisiologis normal, terdapat auto regulasi di aliran darah serebral, namun tindakan pembedahan dapat mengganggu auto regulasi aliran darah serebral ini. Akibatnya, perfusi otak menurun dan tekanan intrakranial meningkat dan yang oleh karena itu dapat merusak otak.…”

Effects of White Noise on Pain Scores and Salivary Cortisol Levels in Surgical Neonates

“…4 The painful tissue damage during surgery can result in a neuroendocrine stress response and increased cortisol levels. 5 Undertreated postoperative pain may hinder the growth of neonates and cause lifelong adverse effects, such as increased pain sensitivity and altered neurodevelopment. 6 Nonpharmacological interventions are recommended for the management of mild pain and are combined with analgesics for moderate and severe pain.…”

“…Postoperative pain in neonates can be described as acute episodic pain initially, which may be experienced for longer than 30 minutes but does not always lead to chronic pain 4. The painful tissue damage during surgery can result in a neuroendocrine stress response and increased cortisol levels 5. Undertreated postoperative pain may hinder the growth of neonates and cause lifelong adverse effects, such as increased pain sensitivity and altered neurodevelopment 6…”