Application effect of dexmedetomidine combined with remifentanil in patients with stroke undergoing interventional thrombectomy and its influence on cerebral metabolism and antioxidation

Zhang Ning; Cheng Yan; Liu Yongtang; Han Wei; Ji Hui; Huang Yongjun

doi:10.3760/j.issn.1673-4777.2025.03.012

Abstract：Objective To investigate the application effect of dexmedetomidine combined with remifentanil in patients with stroke undergoing interventional thrombectomy and its influence on cerebral metabolism and antioxi-dation.Methods A total of 96 patients with ischemic stroke admitted to Affiliated Hospital of Hebei University of Engineering from January 2022 to December 2023 were selected.According to the random number table method,they were divided into the control group and the observation group,with 48 cases in each group.All patients received interventional thrombectomy.The control group was given remifentanil anesthesia,and the observation group was given dexmedetomidine anesthesia on the basis of the control group.The cerebral metabolic indexes immediately after anesthesia and 1 h after anesthesia,serum indexes and intracranial pressure before and 1 h after operation,postoperative eye opening time,Ramsay score,and adverse reactions were compared between the two groups.Results The blood oxygen difference of internal jugular vein bulb,blood oxygen content of internal jugular vein,cerebral metabolic rate and oxygen saturation of internal jugular vein bulb in the observation group were higher than those in the control group at 1 hour after anesthesia(all P＜0.05).The serum levels of malondialdehyde,endothelin and superoxide dismutase 1 hour after operation in the two groups were higher than those before operation,but those in the observation group were lower than those in the control group(all P＜0.05).One day after operation,the intracranial pressure levels of the two groups were lower than those before operation,and that of the observation group was lower than that of the control group[(167±20)mmH2O vs(182±22)mmH2O](t=3.524,P=0.001).The postoperative eye opening time of the observation group was shorter than that of the control group[(9.3±1.2)min vs(12.2±2.8)min](t=6.570,P=0.001),and the Ramsay score was higher than that of the control group[(4.3±0.5)vs(4.0±0.6)](t=3.127,P=0.002).Conclusions Dexmedetomidine combined with remifentanil anesthesia in interventional thrombectomy for stroke can improve brain metabolism and antioxidant capacity,reduce oxidative stress and inflammatory reaction,reduce intracranial pressure,promote postoperative recovery,and has certain safety.