异丙酚复合瑞芬太尼维持麻醉在脑缺血再灌注损伤开颅手术中的应用价值

目的评估异丙酚复合瑞芬太尼维持麻醉在脑缺血再灌注损伤开颅手术中的应用价值。方法选取2010-05—2015-05于我院接受开颅手术的100例脑缺血再灌注损伤患者为研究对象,随机分为对照组与观察组,每组各50例。对照组单用瑞芬太尼维持麻醉,观察组则采用异丙酚复合瑞芬太尼维持麻醉,比较2组麻醉不同时间点心率(HR)、平均动脉压(MAP)及内皮素(ET)、丙二醛(MDA)浓度的变化。结果 T2、T3、T4点,观察组MAP高于对照组,其T2、T4时间点心率高于对照组,T3时间点心率低于对照组,上述不同时间段MAP及HR变化对比差异有统计学意义(P0.05);2组麻醉即刻ET、MDA对比差异无统计学意义(P0.05),再灌注1h、3h观察组血浆ET、MDA水平均低于对照组,差异有统计学意义(P0.05)。结论在脑缺血再灌注损伤开颅手术中采用异丙酚复合瑞芬太尼维持麻醉,可稳定患者血流动力学,改善其内皮素、丙二醛水平,且脑保护作用好,值得推广。

The application value of propofol combined with remifentanil in the operation of cerebral ischemia reperfu-sion injury

Objective To assess the value of propofol combined with remifentanil in the maintenance of anesthesia during cerebral ischemia reperfusion injury craniotomy.Methods One hundred cases of cerebral ischemia reperfusion injury in our hos-pital from May 2010 to May 201 5 were selected,and were randomly divided into control group and observation group,each group of 50 cases.The control group was given remifentanil to maintain anesthesia,while the observation group was given propofol combined with remifentanil to maintain anesthesia.The anesthesia different time snack rate (HR),blood pressure (MAP)and endothelin (ET),malondialdehyde (MDA)concentration change of two groups were compared.Results At T2, T3,T4 time points,MAP in observation group was higher than that of control group,snacks rate at the T2,T4 time points was higher than that of control group,which was lower than that of the control group at T3 time point.The differences be-tween MAP and HR at the different time points were statistically significant (P<0.05).There was no significant difference on ET and MDA between the two groups (P>0.05).The plasma levels of ET and MDA in observation group were lower than those in control group at 1-hour and 3-hour,the differences were statistically significant (P<0.05).Conclusion Remifen-tanil and propofol for maintenance of anesthesia in cerebral ischemia reperfusion injury craniotomy,can make the hemodynam-ics stable,improve the ET and MDA levels,with a good cerebral protective effect,it is worthy of promotion.