Zhong Junfeng, Li Yan, Fang Lichao, Han Dan, Gong Chuhao, Hu Shuangyan, Wang Rongguo, Wang Liwei, Yao Rui, Li Beiping, Zhu Yangzi, Yu Youjia
Department of Pain, Shaoxing People's Hospital, Shaoxing, China.
Department of Anesthesiology, Suzhou Xiangcheng People's Hospital, Suzhou, China.
Front Psychiatry. 2022 Feb 25;13:853795. doi: 10.3389/fpsyt.2022.853795. eCollection 2022.
Posttraumatic stress disorder (PTSD) is a frequent and disabling consequence of traumatic events. A previous study found that early use of propofol was a potential risk factor for PTSD. This prospective study aimed to investigate the effect of propofol and sevoflurane on PTSD after emergency surgery in trauma patients.
A total of 300 trauma patients undergoing emergency surgery were randomly divided into two groups and anesthetized with propofol and/or sevoflurane. Perioperative clinical data were collected. The incidence of PTSD was evaluated with the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) in the two groups 1 month after the operation. The relevance of the injury time and CAPS-5 scores was assessed by Spearman correlation analysis. Logistic regression analysis was used to analyze the risk factors for PTSD.
The incidence of PTSD in the propofol group was higher than that in the sevoflurane group 1 month postoperatively (23.2 vs. 12.2%, = 0.014). The injury time was negatively correlated with the CAPS-5 score in the propofol group ( = 0.226 < 0.001). In the logistic regression analysis, the utilization of propofol was an independent risk factor for PTSD ( = 0.017).
Early use of propofol general anesthesia in emergency surgery for trauma patients may increase the risk of PTSD.
www.chictr.org.cn, identifier: ChiCTR2100050202.
创伤后应激障碍（PTSD）是创伤事件常见且致残的后果。先前的一项研究发现，早期使用丙泊酚是PTSD的一个潜在危险因素。这项前瞻性研究旨在调查丙泊酚和七氟醚对创伤患者急诊手术后PTSD的影响。
总共300例接受急诊手术的创伤患者被随机分为两组，分别用丙泊酚和/或七氟醚进行麻醉。收集围手术期临床数据。术后1个月，使用针对《精神疾病诊断与统计手册》第5版的临床医生管理的PTSD量表（CAPS-5）评估两组患者PTSD的发生率。通过Spearman相关性分析评估受伤时间与CAPS-5评分的相关性。采用Logistic回归分析来分析PTSD的危险因素。
术后1个月，丙泊酚组PTSD的发生率高于七氟醚组（23.2%对12.2%，P = 0.014）。在丙泊酚组中，受伤时间与CAPS-5评分呈负相关（r = 0.226，P < 0.001）。在Logistic回归分析中，丙泊酚的使用是PTSD的一个独立危险因素（P = 0.017）。
创伤患者急诊手术中早期使用丙泊酚全身麻醉可能会增加PTSD的风险。
