|
|
|
| Application of Sevoflurane or Propofol in Craniocerebral Surgery and Analysis of Related Factors for Postoperative Outcome |
| FAN Yong, LIAO Xingzhi, LIU Yufang, et al |
| Anesthesia Department of the 904th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China, Jiangsu Wuxi 214000, China |
|
|
|
|
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.
|
|
|
|
|
|
[1] 欧阳一彬,何青龙,鄞曼钿,等.浮动骨瓣减压术联合颅内压监测在颅脑手术的临床应用[J].河北医学,2021,27(6):999-1003.
[2] 楚文强,彭俊祥,李丹玲.基于Logistic回归分析颅脑手术后炎症指标动态变化及对颅内感染的诊断价值[J].护理学报,2023,30(1):22-27.
[3] 杨爱民.盐酸羟考酮麻醉维持和预镇痛处理对重型颅脑损伤急诊手术脑组织保护和早期认知功能的影响[J].临床与病理杂志,2021,41(2):291-297.
[4] 王梦.丙泊酚-瑞芬太尼-七氟醚静吸复合维持麻醉在颅脑肿瘤手术中的麻醉效果及对心功能血清S100β蛋白浓度的影响[J].山西医药杂志,2021,50(20):2908-2911.
[5] McGuigan S,Evered L,Scott DA,et al.Comparing the effect of xenon and sevoflurane anesthesia on postoperative neural injury biomarkers:a randomized controlled trial[J].Med Gas Res,2022,12(1):10-17.
[6] 佚名.《颅脑创伤临床救治指南》(修订版)出版[J].中国现代神经疾病杂志,2007,7(2):192.
[7] 王盾,龙申.七氟醚麻醉在颅内肿瘤患儿手术中的应用效果[J].癌症进展,2021,19(14):1481-1484.
[8] 赵亚娟,景琪,章超,等.右美托咪定对颅脑损伤患者围术期应激反应及炎症反应的影响[J].中国医刊,2022,57(9):1033-1037.
[9] 池锐彬,周卉芬,李超锋,等.血清NSE水平和APACHEⅡ评分预测急性重型颅脑损伤患者临床预后的研究[J].中国急救复苏与灾害医学杂志,2022,17(5):615-619.
[10] 周芬,管义祥.损伤控制理论应用于重型颅脑损伤合并多发伤患者救治中的效果分析[J].重庆医学,2022,51(2):357-360. |
|
|
|
2024, Vol. 30 
