Effects Of Dexmedetomidine Combined With Sevoflurane For Controlled Hypotension On The Renal Function In Craniocerebral Operation

Objective: To explore the effects of dexmedetomidine combined with sevoflurane for controlled hypotension on the renal function in craniocerebral operation. Methods: A total of 90 patients undergoing craniocerebral operation were analyzed retrospectively, and divided into Group A, Group B, and Group C (each n = 30). Patients in Group A and Group B were given controlled hypotension through infusion of dexmedetomidine by a syringe pump and inhalation of sevoflurane after trauma craniotomy, and the mean arterial pressure (MAP) of Group A and Group B was controlled at 50-55 mmHg and 60-65 mmHg, respectively. In contrast, patients in Group C were not given controlled hypotension. The MAP was recorded at the beginning of blood pressure reduction (T0), 60 min after pressure reduced to target level (T1), and 60 min (T2) and 24 h (T3) after blood pressure reduction stopped. Peripheral venous blood was sampled from patients of each group and their creatinine, blood urea nitrogen, cystatin C, and glomerular filtration rate were compared. Results: There was no significant difference in general clinical data among the three groups. The highest MAP at T1 was seen in Group C, followed by Groups B and A (all P<0.05). Group A and Group B showed significantly lower MAP at T1 than that at T0 (both P<0.05). At T1, Group A and Group B showed significantly increased creatinine, blood urea nitrogen, and cystatin C levels compared with Group C, and Group A showed significantly higher levels of them than Group B (all P<0.05). At T2 and T3, Group A showed significantly higher creatinine, blood urea nitrogen, and cystatin C levels than Group B and Group C (all P<0.05). At T0, there was no significant difference among the three groups in glomerular filtration rate (P>0.05), at T1, Group A and Group B showed significantly decreased glomerular filtration rate level compared with Group C (both P<0.05), and at T2 and T3, Group A showed significantly lower glomerular filtration rate than Group B and Group C (P<0.05). Conclusion: Dexmedetomidine combined with sevoflurane is effective in blood pressure reduction in craniocerebral operation. Controlled hypotension to 50-55 mmHg can cause reversible decrease of glomerular filtration function, but 60-65 mmHg is appropriate, so controlled hypotension to 60-65 mmHg is worthy of clinical application.