异丙酚复合瑞芬太尼全凭静脉麻醉对脑膜瘤手术患者的脑保护作用分析

Analysis of cerebral protection of total intravenous anesthesia with propofol and remifentanil for patients with meningiomas surgery

目的对脑膜瘤患者采用异丙酚联合瑞芬太尼进行全凭静脉麻醉,分析其临床脑保护作用。方法 84例脑膜瘤手术患者,随机分为对照组及治疗组,每组42例。对照组采用异丙酚麻醉,治疗组采用异丙酚复合瑞芬太尼全凭静脉麻醉。比较两组患者切开硬膜1 h(T1)、切开硬膜2 h(T2)、缝合硬膜(T3)和手术结束时(T4)血流动力学指标、血气参数、S100B蛋白量及对麻醉方式的满意度。结果两组患者麻醉中均未出现死亡。治疗组T1～T4时平均动脉压(MAP)、心率(HR)和血氧饱和度(SpO_2)水平比较差异无统计学意义(P>0.05);T2～T4时,两组患者MAP、HR和SpO_2水平比较差异具有统计学意义(P<0.05)。T2～T4时,两组患者氧分压(PO_2)和颈静脉血氧饱和度(SjvO_2)水平较本组T1时明显升高,差异具有统计学意义(P<0.05);两组患者各时间点PO_2和SjvO_2水平比较差异无统计学意义(P>0.05)。T2～T4时,两组患者S100B蛋白量均较本组T1时明显增加,但观察组S100B蛋白量低于对照组,差异具有统计学意义(P<0.05)。治疗组患者总满意度为88.1%,高于对照组的69.0%,差异具有统计学意义(P<0.05)。结论在脑膜瘤手术患者中采用异丙酚复合瑞芬太尼全凭静脉麻醉能有效保护脑组织,患者麻醉状态较为稳定,满意度较高,手术指标改善良好,可以促进身体尽快恢复。

Objective To analyze the cerebral protection of total intravenous anesthesia with propofol and remifentanil for patients with meningiomas surgery. Methods A total of 84 patients with meningiomas surgery were randomly divided into control group and treatment group, with 42 cases in each group. The control group was treated with propofol for anesthesia, and the treatment group was treated with remifentanil for anesthesia. Comparison were made on hemodynamic parameters, blood gas parameters, S100B protein content at 1 h after dural incision (Tl), 2 h after dural incision (T2), sature of dura (T3) and end of operation (T4) and satisfaction with anesthesia methods between the two groups. Results No death occurred during anesthesia in both groups. There was no statistically significant difference in mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO2) at T1 ~ T4 in treatment group (P>0.05). There were statistically significant difference in the levels of MAP, HR and SpO2 between the two groups at T2 ?T4 (P<0.05). At T2 ?T4, the oxygen partial pressure (PO2) and jugular venous oxygen saturation (SjvO2) levels in the two groups were significantly higher than those at Tl, and the difference was statistically significant (P<0.05). There was no statistically significant difference in P02 and SjvO2 levels between the two groups at different time points (P>0.05). At T2 ~ T4, the protein content of S100B in the two groups was significantly higher than that at T1 group, but the content of S100B protein in the treatment group was lower than that in the control group. Their difference was statistically significant (P<0.05). The treatment group had higher total satisfaction degree as 88.1% than 69.0% in the control group, and the difference was statistically significant (P<0.05). Conclusion Intravenous anesthesia with propofol combined with remifentanil can effectively protect brain tissue in patients undergoing meningioma surgery with stable anesthesia status, high satisfaction, well-improved operation index, along with promoting the recovery of the body as soon as possible.