丙泊酚靶控输注与七氟醚麻醉用于急诊创伤性脑外科手术：结局比较

Target-controlled Infusion Propofol Versus Sevoflurane Anaesthesia for Emergency Traumatic Brain Surgery: Comparison of the Outcomes.

作者信息

Hassan Wan Mohd Nazaruddin Wan, Nasir Yusnizah Mohd, Zaini Rhendra Hardy Mohamad, Shukeri Wan Fadzlina Wan Muhd

机构信息

Department of Anaesthesiology, School of Medical Sciences, Jalan Sultanah Zainab II, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.

出版信息

Malays J Med Sci. 2017 Oct;24(5):73-82. doi: 10.21315/mjms2017.24.5.8. Epub 2017 Oct 26.

DOI:10.21315/mjms2017.24.5.8

PMID:29386974

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5772817/

Abstract

BACKGROUND

The choice of anaesthetic techniques is important for the outcome of traumatic brain injury (TBI) emergency surgery. The objective of this study was to compare patient outcomes for target-controlled infusion (TCI) of propofol and sevoflurane anaesthesia.

METHODS

total of 110 severe TBI patients, aged 18-60, who underwent emergency brain surgery were randomised into Group T (TCI) ( = 55) and Group S (sevoflurane) ( = 55). Anaesthesia was maintained in Group T with propofol target plasma concentration of 3-6 μg/mL and in Group S with minimum alveolar concentration (MAC) of sevoflurane 1.0-1.5. Both groups received TCI remifentanil 2-8 ng/mL for analgesia. After the surgery, patients were managed in the intensive care unit and were followed up until discharge for the outcome parameters.

RESULTS

Demographic characteristics were comparable in both groups. Differences in Glasgow Outcome Scale (GOS) score at discharge were not significant between Group T and Group S ( = 0.25): the percentages of mortality (GOS 1) [27.3% versus 16.4%], vegetative and severe disability (GOS 2-3) [29.1% versus 41.8%] and good outcome (GOS 4-5) [43.6% versus 41.8%] were comparable in both groups. There were no significant differences in other outcome parameters.

CONCLUSION

TCI propofol and sevoflurane anaesthesia were comparable in the outcomes of TBI patients after emergency surgery.

摘要

背景

麻醉技术的选择对于创伤性脑损伤（TBI）急诊手术的结果至关重要。本研究的目的是比较丙泊酚靶控输注（TCI）和七氟醚麻醉对患者的影响。

方法

将110例年龄在18至60岁之间接受急诊脑外科手术的重度TBI患者随机分为T组（TCI组）（n = 55）和S组（七氟醚组）（n = 55）。T组通过丙泊酚靶血浆浓度维持在3-6μg/mL进行麻醉，S组通过七氟醚最低肺泡浓度（MAC）维持在1.0-1.5进行麻醉。两组均接受瑞芬太尼2-8 ng/mL的TCI用于镇痛。手术后，患者在重症监护病房接受治疗，并随访至出院以观察结局参数。

结果

两组的人口统计学特征具有可比性。T组和S组出院时的格拉斯哥预后量表（GOS）评分差异不显著（P = 0.25）：两组的死亡率（GOS 1）[27.3%对16.4%]、植物状态和严重残疾（GOS 2-3）[29.1%对41.8%]以及良好预后（GOS 4-5）[43.6%对41.8%]相当。其他结局参数无显著差异。