Neuroprotective Effect of Dexmedetomidine on Patients Undergoing Craniotomy and Clipping of Intracranial Aneurysm

OBJECTIVE To evaluate the neuroprotective effect of dexmedetomidine(DEX) on patients undergoing craniotomy and clipping of intracranial aneurysm. METHODS Sixty patients undergoing craniotomy and intracranial aneurysm clipping were randomized into 2 groups each containing 30 subjects. In dexmedetomidine group, before induction of anesthesia DEX was administered with a loading dose of 1 μg·kg^-1 followed by maintenance dose of 0.5 μg·kg^-1·h^-1, while the same dose of normal saline was administered in control group. Before anesthesia induction(T₀), beginning of blocking the artery of intracranial aneurysm(T₁), end of blocking the artery of intracranial aneurysm surgery(T₂)，end of surgery(T₃), 24 h after end of surgery(T₄) and 72 h after end of surgery(T₅), venous blood samples from jugular bulb catheters were drawn, serum content of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), interleukin-10(IL-10), beta isoform of S100 protein in astrocytes(S-100β protein) and neuron-specific enolase(NSE) were determined by ELISA. RESULTS From T₁ to T₃, the serum concentrations of TNF-α, IL-6, IL-10, S-100β and NSE in 2 groups were significantly higher than those at T₀(P<0.05); the serum content of TNF-α, IL-6, S-100β and NSE were significantly lower in dexmedetomidine group than that in control group(P<0.05); the serum concentrations of IL-10 was significantly higher in dexmedetomidine group than that in control group(P<0.05). CONCLUSION DEX can reduce the expression of proinflammatory factors and nerve injury markers, and increase the expression of anti-inflammatory molecules. It has neuroprotective effect on patients undergoing craniotomy and clipping of intracranial aneurysm.