镇痛镇静对急诊重症蛛网膜下腔出血患者脑氧代谢的影响.

Objective: To study the effect of analgesia and sedation on cerebral metabolism in patients with severe subarachnoid hemorrhage. Methods: 80 patients with severe subarachnoid hemorrhage were given sufentanil and midazolam in treatment. After sedation and analgesia, lh. 6h. carotid and jugular venous oxygen saturation, central venous oxygen saturation and cerebral oxygen metabolism indexes were compared before and after sedation and analgesia in 2h. 3h, and after analgesia. Results: All patients before and after sedation carotid arterial oxygen saturation did not change significantly, were 0.88 ± 0.19, 0.80 ± 0.15,0.82 ± 0.12,0.84 ± 0.15, 0.85 ± 0.15. Jugular vein and central venous oxygen saturation before sedation is low (0.48 ± 0.07, 0.50 ± 0.05), 2h back to normal after sedation (0.65 ± 0.11, 0.69 ± 0.13), at the end of 1h after sedation (0.58 ± 0.090.61 ± 0.10), 3h (0.51 ± 0.08, 0.56 ± 0.10) and 6h (0.49 ± 0.03, 0.52 ± 0.07) decreased, close to the level before sedation. There was no significant change in CaO2 before and after sedation in all patients (P>0.05).The CjvO2 after analgesic and sedative were significantly higher than before analgesic and sedative (P<0. 05), CERO2 and Da-jvO2 after analgesic and sedative were significantly lower than before analgesic and sedative (P<0.05). Conclusion: Analgesia and sedation could reduce the cerebral oxygen metabolism in patients with severe subarachnoid hemorrhage. [ABSTRACT FROM AUTHOR]