Abstract:Objective: To explore the application of sevoflurane or propofol in craniocerebral surgery, and analyze the relevant factors affecting the prognosis of patients after craniocerebral surgery. Methods: A total of 144 patients undergoing craniocerebral surgery in our hospital from March 2020 to March 2022 were selected as the study subjects. They were divided into sevoflurane group and propofol group according to the randomized double-blind method, with 72 patients in each group. The sevoflurane group received sevoflurane inhalation anesthesia, while the propofol group received propofol intravenous anesthesia. The serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), neuron specific enolase (NSE), acute physiological and chronic health (APACHRE) II scores, and Glasgow coma score (GCS) were compared between the two groups.According to the GCS score, the patients were divided into a poor outcome group (GCS ≤ 11 points, 21 cases) and a good outcome group (GCS>11 points, 123 cases). Logistic regression analysis was used to analyze the factors affecting the postoperative outcome of the patients. Results: There was no significant difference in CRP, IL-6 and NSE levels and differences between sevoflurane group and propofol group before and 1 day after surgery (P>0.05). There was no significant difference in 3d APACHEⅡ and GCS scores and differences between sevoflurane group and propofol group before and after surgery (P>0.05). Compared with the group with good outcome, the group with poor outcome had a higher age, longer surgical time, lower admission GCS scores, and a higher proportion of admission pupil dilation, hypotension, gastrointestinal bleeding, and pulmonary infection (P<0.05). Logistic regression analysis showed that age, surgical time, and admission GCS score were the influencing factors for poor postoperative outcome in patients undergoing craniocerebral surgery (P<0.05). Conclusion: Compared with propofol, maintenance anesthesia with sevoflurane during craniocerebral surgery has no significant impact on poor postoperative outcome. Age, surgical time, and admission GCS score are the influencing factors for poor postoperative outcome in patients undergoing craniocerebral surgery.
樊勇, 廖兴志, 刘宇芳, 陆海波, 肖骥峰. 七氟烷或丙泊酚在颅脑术中的应用及术后转归相关因素分析[J]. 河北医学, 2024, 30(4): 692-697.
FAN Yong, LIAO Xingzhi, LIU Yufang, et al. Application of Sevoflurane or Propofol in Craniocerebral Surgery and Analysis of Related Factors for Postoperative Outcome. HeBei Med, 2024, 30(4): 692-697.