Lara-Contreras R, Martínez-Ramírez S

Language: Spanish
References: 13
Page: 49-56
PDF size: 102.61 Kb.

ABSTRACT

Introduction. In recent years, the literature has supported the use of drills for evacuation of hematoma closed a technique less invasive than craniotomy.
Material and methods. They conducted a study in patients from Central Military Hospital operating room area during the period from January 1 to September 30, 2008, to which the procedures were performed drainage of chronic subdural hematoma. To determine the physical status classification was used by the American Association of Anesthesiologists (ASA), and the clinical condition grading scale used clinically Bender
Results. Nineteen patients with diagnosis of a chronic subdural hematoma were captured for close drainage with local anesthesia and sedation with Dexmedetomidine, which were classified according to the Richmond Agitation- Sedation Scale. While one patient was very agitated, three patients agitated and the rest alert and calm. Fourteen patients were found in Bender’s Scale grade 1 and five in grade 2. Previous written informed consent, a dose of dexmedetomidine a rate of 1.5 µg/kg, i.v. was administered with a total dose average of 105 µg/kg. At the end of administration, twelve patients reached moderate sedation and six deep sedation.
During the surgery, eighteen patients reached a deep sedation that allowed the nerve block and the closed drainage of the hematoma. With a pressure average of 98 mmHg, heart rate 58 beats per minute, while the respiratory rate remained at an average of 14 and SaO2 in 99%.
In one patient moderate sedation reached was maintained during nerve block, with the incision of the skin the patient around very agitated, was necessary to implement a bolus of fentanyl of 70 µg in addition of 1.5 mg of Midazolam, with which reached a deep sedation that allowed the surgical procedure.
Conclusion. In an effort to reduce cases of failed sedation, improvement in the percentage of adverse events and reduce the time of recovery in patients undergoing drainage of chronic subdural hematoma, the use of dexmedetomidine a agonist α2 adrenergic highly selective which owns analgesic and sedatives effects, can be a good choice in the management of these patients.

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