摘要
Objective:In this study, the effects of combined anesthesia with Remifentanil and Propofol on the hemodynamics and stress state indexes at different times in patients undergoing craniotomy were studied, and the effects of combined anesthesia with Remifentanil and Propofol on neurological function and inflammatory response in patients undergoing craniotomy were explored.Methods:A total of 92 patients who underwent craniotomy in our hospital from January 2017 to February 2019 were collected and divided into observation group and control group according to their anesthesia methods. 45 patients in the control group received propofol to maintain anesthesia. In the observation group, 47 cases were treated with remifentanil combined with propofol to maintain anesthesia. Changes in hemodynamics (HR, SpO2, MAP) of the two groups were monitored at different times throughout the operation. At the same time by ria method detection in patients with two groups of T0, T1, T2, T3, T4 in serum stress state index (AngⅡ, NE, ALD) changes. The changes of nerve function indexes (NSE, S100) and inflammatory factors (CRP, TNF-α) before and after surgery were compared between the two groups.Results:There were no significant differences in hemodynamics and stress state indicators of T0 between the two groups, and there were no significant differences in preoperative inflammatory reaction and neurological function indicators between the two groups. In the observation group, the changes of HR, SpO2 and MAP at each time point during the operation were less than those in the control group, and the hemodynamic state of the observation group was more stable than that of the control group. The level of AngⅡ, NE, ALD in Control patients in T1, T2, T3, T4 were higher than T0. The level of AngⅡ, NE, ALD of the two groups in T1, T2, T3, T4 are higher than T0. Observation group of patients with T1, T2, T3, T4 AngⅡ level obviously is higher than the control group with time. In the observation group, the levels of NE and ALD were higher at T2, T3 and T4 than at T0. The levels of NE and ALD in T3 and T4 were lower in the observation group than in the control group. Postoperative neurological function (NSE, S100) and inflammatory factors (CRP, TNF-α) were significantly higher in the two groups than in the control group.Conclusion: Combined anesthesia with Remifentanil and Propofol can stabilize the hemodynamic state of patients undergoing craniotomy, reduce cardiovascular stress response and inflammatory response, reduce nerve damage, and play a role in brain protection.
作者简介
Corresponding author:Cheng-Long Liu,Department of Anesthesia,Gaoyou People's Hospital,Gaoyou,225600,Jiangsu Province,China.
