Abstract：Objective: To study the effect of remifentanil compounded with propofol on brain protection and inflammatory factors in patients undergoing aneurysm clipping. Methods: A total of 105 patients who came to our hospital for cerebral aneurysm clipping from January 2019 to December 2021 were selected as the research subjects, and were retrospectively analyzed. According to the different anesthesia induction methods,the observation group (remifentanil complex propofol, 55 cases) and the control group (conventional fentanyl anesthesia, 50 cases) were compared between the two groups of patients before anesthesia induction (T0), 1 h after induction (T1), after surgery (T2), and 6 h after surgery (T3), and cerebral oxygen metabolism and inflammatory factors at 5 time points 12 h (T4) after operation. The recovery and cognitive status of the two groups of patients were compared. Results: The results of repeated measures ANOVA showed that the anesthesia induction method, time, and the interaction of both affected CERO2, CjvO2, and Da-jvO2 (P<0.05). CERO2, CjvO2, and Da-jvO2 will change significantly with the trend of the time point. CERO2 and CjvO2 overall show a trend of rising first and then decreasing. CERO2 gradually decreases from the time point T1, and Da-jvO2 mainly shows the time point trend of decreasing, and gradually decreases from the time point T0. The effects of the anesthesia induction method, time, and the interaction effect on S100 β and NSE were all statistically significant (P<0.05). S100 β and NSE increased with time, and the trend was more obvious than the control group (P<0.05); the effect of time on IL-6 was statistically significant (P<0.05), but slightly increased over time; and the interaction of anesthesia induction method was not statistically significant on IL-6 (P>0.05). The observed force recovery time, eye opening time and extubation time were lower than that of the control group, statistically significant (P<0.05), but there was no difference in respiratory recovery time between the two groups (P>0.05). The effect of anesthesia induction method and time on MMSE and OAAS score were statistically significant (P<0.05). The interaction between method and time had little effect on MMSE scores (P>0.05) and a statistically significant effect on OAAS scores (P<0.05), and MMSE and OAAS scores in both groups, and the observation group was significant compared with the control group (P<0.05). Conclusion: Remifentanil compounded with propofol can significantly protect the brain of patients undergoing aneurysm clipping, and can increase the inflammatory response, but the recovery time, consciousness and cognitive function recovery are more superior.
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2023, Vol. 29 
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