舒芬太尼复合丙泊酚用于中重度颅脑损伤术后镇痛镇静对患者认知功能及脑组织代谢的影响

Effects of Sufentanil Combined with Propofol for Postoperative Analgesia and Sedation on Cognitive Function and Brain Tissue Metabolism in Patients with Moderate to Severe Craniocerebral Injury

目的:观察舒芬太尼复合丙泊酚用于中重度颅脑损伤术后镇痛镇静对患者认知功能及脑组织代谢的影响。方法:选择2018年2月-2020年2月本院收治的中重度颅脑损伤患者82例,按随机数字表法将其分为两组,各41例。对照组给予舒芬太尼麻醉处理,观察组于对照组基础上静脉注射丙泊酚麻醉处理。比较两组镇静-躁动评分(SAS)、视觉模拟评分法(VAS)评分、认知功能、颈内静脉氧饱和度(SjvO2)、中心静脉氧饱和度(ScvO2)及不良反应发生情况。结果:用药前,两组VAS评分、SAS评分、简易精神状态评价量表(MMSE)评分、SjvO2、ScvO2水平比较,差异均无统计学意义(P>0.05)。用药后,两组VAS评分、SAS评分均下降,且观察组均低于对照组,差异均有统计学意义(P<0.05)。用药后,两组MMSE评分均下降,但观察组MMSE评分高于对照组,差异均有统计学意义(P<0.05)。用药后,两组SjvO2、ScvO2水平均升高,且观察组SjvO2、ScvO2水平均高于对照组,差异均有统计学意义(P<0.05)。观察组的不良反应发生率为4.88%,与对照组的2.44%比较,差异无统计学意义(P>0.05)。结论:舒芬太尼、丙泊酚复合麻醉用于中重度颅脑损伤术后镇痛镇静安全可行,能够改善脑组织代谢水平,且对认知功能影响小,是一种较为理想的麻醉方案。

Objective:To observe the effect of Sufentanil combined with Propofol for postoperative analgesia and sedation on cognitive function and brain tissue metabolism in patients with moderate and severe craniocerebral injury.Method:Eighty-two patients with moderate to severe craniocerebral injury admitted to our hospital from February 2018 to February 2020 were selected.According to the random number table method,they were divided into two groups,41 cases in each group.The control group was given Sufentanil anesthesia,the observation group was anesthetized by intravenous injection of Propofol on the basis of the control group.The sedation agitation score(SAS),visual analogue scale(VAS),cognitive function,internal jugular vein oxygen saturation(SjvO2),central venous oxygen saturation(ScvO2)and adverse reactions were compared between the two groups.Result:Before medication,there were no significant differences in VAS score,SAS score,MMSE score,SjvO2 and ScvO2 levels between the two groups(P>0.05).After medication,the VAS score and SAS score of the two groups decreased,and the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).After medication,the MMSE scores of the two groups decreased,but the MMSE score of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).After medication,the levels of SjvO2 and ScvO2 in the two groups were increased,and the levels of SjvO2 and ScvO2 in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 4.88%,compared with 2.44%in the control group,the difference was not statistically significant(P>0.05).Conclusion:Sufentanil and Propofol combined anesthesia is safe and feasible for postoperative analgesia and sedation of moderate and severe craniocerebral injury,can improve brain tissue metabolism level,and has little impact on cognitive function,so it is an ideal anesthesia scheme.