重型颅脑损伤丙泊酚麻醉临床分析

Clinical Analysis of Propofol Anesthesia in Severe Ccraniocerebral Injury

目的重型颅脑损伤丙泊酚麻醉对血流动力学、术后镇痛镇静效果的作用分析。方法2018年1月-2018年10月收治的重型颅脑损伤患者74例,按照麻醉方案的不同分成两组,A组(36例,丙泊酚),B组(38例,咪达唑仑),围术期血流动力学,血浆各项指标以及术后镇痛效果比较。结果T4、T5时间段,A组SOD指标高于B组,MDA、Glu水平低于B组,比较P<0.05。血流动力学心率指标、MAP指标,A组各时间段数据监测比较无显著变化,B组在T3、T5时间段指标高于T1、T2、T4时间段,且高于A组,P<0.05。术后A组VAS评分为(2.06±0.14),B组VAS评分为(2.97±0.72),两组比较差异有统计学意义,P<0.05。结论重型颅脑损伤丙泊酚麻醉具有起效快,血流动力学稳定,术后镇痛镇静效果好;同时手术中降低应激反应,提高对脑保护的作用。

Objective To analyze the effect of propofol anesthesia on hemodynamics and postoperative analgesia and sedation after severe craniocerebral injury.Methods 74 patients with severe traumatic brain injury from January 2018 to October 2018,Divided into two groups according to the different anesthetic regimens,A group(36 cases,propofol),B group(38 cases,midazolam),perioperative hemodynamics,various indexes of plasma and comparison of postoperative analgesic effect.Results At T4,T5,the SOD index in group A was higher than that in group B,and the level of MDA,Glu in group A was lower than that in group B(P<0.05).Hemodynamic heart rate index,M There was no significant change in AP in each period of time in group A.The indexes in group B were significantly higher than those in group T1,T2 and T4 at T3,T5 and T4,and were significantly higher than those in group A(P<0.05).The VAS score of group A(2.06±0.14),B was(2.97±0.72),compared with that of group A(2.97±0.72)(P<0.05).Conclusion Propofol anesthesia for severe craniocerebral injury has the advantages of quick effect,stable hemodynamics,good analgesic and sedative effect after operation,at the same time,it can reduce the stress response during operation and improve the effect of brain protection.