Objective To explore the effect of dexmedetomidine in the craniotomy of patients with hypertensive cerebral hemorrhage. Methods Sixty cases of patients with hypertensive cerebral hemorrhage admitted to our hospital from February 2012 to May 2015 were selected and randomly divided into two groups, with 30 cases in each group. The experimental group received intravenous injection with dexmedetomidine in the dose of 2μg•kg-1•h-1 for 15 min before induction of anesthesia, and then received 0.5μg•kg-1•h-1 dexmedetomidine for maintained anesthesia until the end of operation;the control group received intravenous injection with normal saline before induction of anesthesia , then received intravenous injection of propofol (3 mg•kg-1•h-1) for maintained anesthesia until the end of operation. The hemodynamics at different time points, including T0 (entering the operating room), T1 (after application of dexmedetomidine or normal saline), T2 (after intubation), T3 (scalp incision) and T4 (when spontaneous breathing recovery) were recorded, and the surgical adverse events were analyzed. Results The hemodynamics indicators at T1, T2 and T3 of experimental group were significantly better than those of control group (P<0.05). The incidences of hypotension, tachycardia, cough and restlessness during operation of experimental group were significantly lower than those of control group (P<0.05). Conclusions The application of dexmedetomidine in the craniotomy of patients with hypertensive cerebral hemorrhage can effectively stabilize patients' hemodynamics, and reduce the incidence of surgical adverse events.%目的：探讨右美托咪定在高血压脑出血患者开颅手术中的临床应用效果。方法选取2012年2月至2015年5月我院收治的60例高血压脑出血的患者，随机分为两组各30例。实验组在诱导麻醉前泵入右美托咪定，以2μg•kg-1•h-1的剂量静注15 min，后以0.5μg•kg-1•h-1的速度静脉注射右美托咪定维持麻醉至手术结束；对照组泵入生理盐水，以3 mg•kg-1•h-1的速度静脉注射丙泊酚维持麻醉至手术结束。对两组入室时（T0)、应用右美托咪定或生理盐水后（T1)、插管后（T2)、切头皮时（T3)、自主呼吸恢复时（T4)的血流动力学及手术不良事件进行分析。结果在T1、 T2、 T3时，实验组的血流动力学指标均显著优于对照组（P<0.05)。两组不良事件相比，实验组术中的低血压、心动过速、呛咳、躁动的发生率均低于对照组，差异有统计学意义（P<0.05)。结论右美托咪定在高血压脑出血患者开颅手术中可有效稳定患者的血流动力学，并减少手术不良事件的发生。
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