Effects of Propofol and Remifentanil on Oxygen Metabolism and S100β BDNF Aβ-42/tau in elderly Patients with Hypertension Undergoing Abdominal Surgery
DONG Tao
The Second Clinical Medical College of Inner Mongolia University for Nationalities / Inner Mongolia Forestry General Hospital, Inner Mongolia Yakeshi 022150, China
Abstract：Objective: To study the effects of propofol and remifentanil on oxygen metabolism and S100 β, BDNF,Aβ-42/tau in elderly patients with hypertension undergoing abdominal surgery. Methods: 80 elderly hypertensive patients undergoing general anesthesia tracheal intubation and abdominal surgery were selected from January 2017 to May 2018. They were randomly divided into control group and observation group, with 40 cases in each group. The control group was maintained with propofol anesthesia; the observation group was anesthetized with propofol and remifentanil. The sphygmomanometer heart rate changes at different time points during the operation were compared between the two groups. The intraoperative esmolol and nitroglycerin levels, respiration recovery time, resuscitation time, catheter removal time, and incidence of adverse reactions after resuscitation were recorded. And the levels of cerebral oxygen metabolism, serum S100 β, brain-derived neurotrophic factor (BDNF), Aβ -42, and tau-181 were compared. Results: The systolic blood pressure, diastolic blood pressure and heart rate of the control group and the observation group at the time of extubation (T3) were significantly higher than before (T1), after the completion of surgery (T2), and after the extubation (T4), and the differences were statistically significant. Significance (P<0.05). Respiratory recovery time, resuscitation time and organ extraction time of the control group were all later than those of the observation group, and the use of esmolol and nitroglycerin were both higher than the observation group, and the difference was statistically significant (t=10.300,P=0.000; t=13.172,P=0.000;t=9.077, P=0.000; t=6.314, P=0.000; t=11.744, P=0.000). There was no difference in CERO2 and Da-jvO2 in the two groups at T1 (P>0.05), and the indexes in the observation group were lower than those in the control group at the beginning of operation (T5), 0.5 h after operation (T6) and T2 (t=3.445, P=0.001, t=4.551, P=0.000, t=3.894, P=0.000; t=3.571, P=0.001, t=5.489, P=0.000, t=4.112, P=0.000). There was no difference in serum S100 β, BDNF, A β-42 and tau-181 between the two groups at T1 (t=0.735, P=0.465; t=0.588, P=0.558; t=0.262, P=0.794; t=0.261, P=0.795). The serum levels of S100 β, A β -42 and tau-181 in the observation group were lower than those in the control group, while the levels of serum BDNF in the observation group were higher than the control group (t=6.914, P=0.000, t=11.524, P=0.000, t=6.600, P=0.000; t=3.267, P=0.002, t=4.746, P=0.000, t=3.665, P=0.000; t=5.941, P=0.000, t=6.521, P=0.000, t=4.406, P=0.000; t=2.919, P=0.005, t=4.282, P=0.000, t=4.047, P=0.000). The incidence of lethargy, abnormal blood pressure, abnormal heart rate, nausea and vomiting were not statistically significant in the two groups (χ2=0.346, P=0.556; χ2=0.000, P=1.000; χ2=1.013, P=0.314; χ2=0.346, P=0.556). Conclusion: The blood pressure and heart rate were stable during the operation by propofol combined with remifentanil, and the amount of antihypertensive drugs was effectively reduced. It has little effect on cerebral oxygen metabolism and brain nerve cells. The postoperative recovery was rapid and it was helpful to shorten the operating room residence time.
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2019, Vol. 25 
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