Objective To investigate the effect of low-dose dexmedetomidine on mechanical thrombectomy in patients with acute ischemic stroke(AIS)and its effect on serum CNS-specific protein(S100β)and plasma cysteine-rich protein 61(CCNI)levels.Methods A total of 89 patients with AIS who underwent interventional mechanical thrombectomy from January 2018 to December 2021 were selected and randomly divided into 3 groups:control group,low-dose group,and high-dose group.The control group(29 cases)was injected with the same volume of normal saline,and the low-dose group(30 cases)and the high-dose group(30 cases)were intravenously injected with dexmedetomidine 1.0 μg/(kg·h)10 minutes before induction of anesthesia).The maintenance doses after 0.4 and 0.8 μg/(kg·h)until the trachea was extubated.The serum S100β protein and CCNI protein of the three groups were detected before administration in the room(T0),after induction of anesthesia(T1),infusion of dexmedetomidine for 10 minutes(T2),and recovery of spontaneous breathing with a tube after the operation(T3),and the differences in sedation,NIHSS score,puncture-vascular recanalization(PTR)time,recovery time,and the incidence of agitation and delirium at 24 hours after surgery were compared among the three groups.Results There was no significant difference in serum S100β protein and CCNI protein between T1-T3 and T0 in the control group(P＞0.05),Serum S100β protein and CCNI protein at T1-T3 in low-dose group and high-dose group were significantly lower than those at T0(P＜0.05).At T0,the serum S100β protein and CCNI protein of the three groups had no statistical significance(P＞0.05);at T1to T3,the serum S100β protein and CCNI protein of the low-dose group and high-dose group were significantly lower than those of the control group,and the low-dose group was significantly lower than the control group.group was significantly lower than the high-dose group(P＜0.05).The Ramsay score,NIHSS score,PTR and recovery time of the low-dose group and high-dose group at 24 hours after operation were better than those of the control group(P＜0.05).However,there was no significant difference in Ramsay score,PTR and wake-up time between the two groups(P＞0.05).The incidence of agitation and delirium in the low-dose group and high-dose group was significantly lower than that in the control group(P＜0.05),but there was no significant difference between the low-dose and high-dose groups(P＞0.05).The incidences of hypotension and bradycardia in the high-dose group were significantly higher than those in the low-dose group and the control group(P＜0.05),but there was no significant difference between the low-dose group and the control group(P＞0.05).Conclusion High and low doses of dexmedetomidine can reduce the levels of SI00β protein and CCNI protein during mechanical thrombectomy in patients with AIS.1.0 μg/(kg·h)infusion and low-dose[0.4 μg/(kg·h)]have obvious sedative effects during anesthesia maintenance,which can significantly reduce neurological damage without increasing adverse reactions.
Acute ischemic strokeDexmedetomidineThrombectomyCNS-specific proteinCysteine-rich protein 61
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