Effects of etomidate and propofol on cognitive function and brain injury in intracranial aneurysm interventional therapy
Objective To compare the effects of etomidate and propofol on cognitive function and brain injury in intracranial aneurysm interventional therapy.Method A total of 98 patients with intracranial aneurysms undergoing interventional treatment admitted to the First Hospital of Zhangjiakou City in Hebei Province from August 2021 to August 2023 were selected as the study objects.They were divided into control group and observation group by random number table method based on the principle of comparison of baseline features between groups,with 49 cases in each group.The control group was given propofol injection during anesthesia induction and maintenance,and the observation group was given etomidate injection during anesthesia induction and maintenance.The perioperative relevant indexes,cognitive function(MMSE scores)before and 3 and 7 days after surgery,Hemodynamic levels(MAP,HR,SBP,DBP)before anesthesia induction(T0),5 min after tracheal intubation(T1),at the beginning of surgery(T2),and at the end of surgery(T3)were compared between the two groups.The inflammatory response and the degree of brain injury(TNF-α,IL-6,iNOS,NSE)before and 3 days after surgery and the occurrence of postoperative adverse reactions were compared between the two groups.Result The loss time of consciousness and recovery time of spontaneous respiration in observation group were shorter than those in control group,and the differences were statistically significant(P＜0.05).Before surgery,there were no significant differences in MMSE scores between the two groups(P＞0.05).At 3 and 7 days after surgery,MMSE scores in two groups were decreased than those before surgery,but the observation group was higher than the control group,with statistical significance(P＜0.05).At T0,there were no significant differences in MAP,HR,SBP and DBP between the two groups(P＞0.05).At T1,T2 and T3,MAP,SBP and DBP in two groups were decreased than those at T0,but the observation group was higher than the control group,with statistical significance(P＜0.05).Before surgery,there were no significant differences in TNF-α,IL-6,iNOS and NSE levels between the two groups(P＞0.05).3 days after surgery,the levels of TNF-α,IL-6,iNOS and NSE in two groups were increased than those before surgery,but the observation group was lower than the control group,with statistical significance(P＜0.05).There was no significant difference in the total incidence of postoperative adverse reactions between the two groups(P＞0.05).Conclusion Compared with propofol,etomidate can significantly improve the cognitive function of patients with intracranial aneurysm interventional therapy,and maintain the stable hemodynamic level of patients,and reduce the inflammatory response of patients and the degree of brain injury,with good safety.
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