丙泊酚静脉麻醉对骨科手术患者麻醉效果及炎性细胞因子的影响

Effect of Propofol Intravenous Anesthesia on the Anesthesia Effect and Inflammatory Cytokines in Patients Undergoing Orthopedic Surgery

目的探讨丙泊酚静脉麻醉对骨科手术患者麻醉效果及炎性细胞因子IL-6、IL-10和TNF-α浓度的影响。方法选取2018年1月~2019年12月我院收治的106例骨科手术患者,按随机数字表法分为对照组和研究组,每组53例。对照组使用七氟醚吸入麻醉,研究组使用丙泊酚静脉麻醉,比较两组麻醉效果、血清氧化应激反应变化情况、血流动力学变化情况、血清炎性细胞因子水平变化情况。结果研究组拔管后镇静评分低于对照组,拔管时间、麻醉苏醒时间短于对照组,差异有统计学意义(P<0.05);两组术后2 h SOD较术前下降,MDA、NO较术前上升,研究组术后2 h SOD高于对照组,MDA、NO低于对照组,差异有统计学意义(P<0.05);研究组插管即刻、插管后即刻HR低于对照组,差异有统计学意义(P<0.05);研究组术后2、24 h TNF-α、IL-6水平均低于对照组,IL-10水平高于对照组,差异有统计学意义(P<0.05)。结论骨科手术患者使用丙泊酚静脉麻醉可缩短麻醉苏醒时间,降低氧化应激反应,对血流动力学影响较小,可有效抑制术后炎症的发生,麻醉效果确切。

Objective To explore the effect of propofol intravenous anesthesia on the anesthesia effect and the concentration of inflammatory cytokines IL-6,IL-10 and TNF-αin orthopedic surgery patients.Methods A selection of 106 orthopedic surgery patients admitted to our hospital from January 2018 to December 2019 were divided into a control group and a study group according to a random number table,with 53 cases in each group.The control group used sevoflurane inhalation anesthesia,and the study group used propofol intravenous anesthesia.The anesthesia effects,changes in serum oxidative stress,changes in hemodynamics,and changes in serum inflammatory cytokine levels were compared between the two groups.Results The sedation score after extubation in the study group was lower than that in the control group,and the extubation time and the time to wake up from anesthesia were shorter than those in the control group,the difference was statistically significant(P<0.05);the SOD of the two groups decreased at 2 h after the operation,and the MDA and NO increased compared with that before the operation.The SOD of the study group was higher than the control group at 2 h,and the MDA and NO were lower than the control group,the difference was statistically significant(P<0.05);The HR of the study group immediately after intubation and immediately after intubation was lower than that of the control group,the difference was statistically significant(P<0.05);the levels of TNF-αand IL-6 in the study group were lower than those of the control group at 2 and 24 h after operation.The level of 10 was higher than that of the control group,the difference was statistically significant(P<0.05).Conclusion Propofol can shorten the anesthesia recovery time and reduce oxidative stress response in patients undergoing orthopedic surgery under intravenous anesthesia.It has little influence on hemodynamics,effectively inhibits postoperative inflammation,and has a significant anesthetic effect.