Abstract PR131

Background & Objectives: Cerebral hemorrhage is often complicated by conscious disturbance and restlessness regardless of the size or location of the hemorrhage, and sedation is often necessary. Dexmedetomidine (DEX) has dose-dependent sedative, anxiolytic and analgesic effects. It is suited to patients undergoing mechanical ventilation for traumatic brain injury; however, its sedative effects cannot easily be controlled in patients breathing spontaneously. This study evaluated the safety and efficacy of postoperative intranasal dexmedetomidine in patients undergoing craniotomy for hypertensive cerebral hemorrhage. Materials & Methods: Sixty patients undergoing hypertensive cerebral hemorrhage were randomly allocated to receive either intranasal saline (Placebo group) or intranasal dexmedetomidine 1.5 μg/kg (DEX group). Study drug, either undiluted dexmedetomidine 1.5 μg/kg (DEX group) or equal volume of saline (Placebo group), will be administered immediately to each naris as drops after craniotomy for evacuation of hematoma. Primary outcomes include systolic blood pressure, diastolic blood pressure, heart rate, peripheral oxygen saturation, intracranial pressure (ICP), Glasgow Coma Scale (GCS) score, the level of inflammatory markers in the cerebrospinal fluid, and the levels of malondialdehyde, superoxide dismutase and corticosteroid in serum. Secondary outcomes are volume of hematoma, body weight, duration of surgery and anesthesia, blood loss, seroma volume of drainage, urine output and length of hospital stay. Results: Weighted areas under the curve (AUCw) of heart rate, systolic blood pressure and intracranial pressure were significantly lower (P < 0.05) with dexmedetomidine. AUCw of GCS scores were also significantly higher in the dexmedetomidine group (P < 0.05). Plasma malondialdehyde, and corticosteroid levels were significantly lower in DEX group as were the cerebrospinal fluid IL-6 and TNF-▫▫ levels (▫▫ < 0.05). Seroma volume of drainage and the length of hospital stay were less in DEX group. Conclusion: Intranasal dexmedetomidine in patients with hypertensive cerebral hemorrhage who are not mechanically ventilated postoperative is safe and effective which can yield better GCS scores, more stable hemodynamic profile and ICP and lower inflammatory and oxidative response. References: 1. Brain Res 2013; 1535:148–155. 2. Neuroscience 2012; 202:474–483. Disclosure of Interest: None declared