Efficacy of combined use of remifentanil,propofol and atracurium cisbenzenesulfonate in postoperative brain protection in patients with severe cerebral hemorrhage
Objective To explore the effect of the combined application of remifentanil with propofol and cisatracurium besylate for postoperative brain protection in patients with severe cerebral hemorrhage.Methods One hundred and twenty patients with severe cerebral hemorrhage treated in Baoji Hospital Affiliated to Xi'an Medical College from January 2019 to December 2023 were selected as the subjects and divided into an observation group and a control group using a randomized numerical table,with 60 in each group.The patients in the control group received imipramine+remifentanil+cisatracurium besylate treatment while those in the observation group received remifentanil+propofol+cisatracurium besylate treatment.The hemodynamics,serum neuron-specific enolase(NSE),S100-β protein,perioperative complications,Critical care Pain Observation Tool(CPOT),Richmond Agitation-Sedation Scale(RASS),Glasgow Coma Scale(GCS)and National Institute of Health stroke scale(NIHSS)were compared between the two groups.Results Postoperative systolic blood pressure,diastolic blood pressure and heart rate of the observation group were lower than those of the control group,and the differences were statistically significant(all P＜0.05).After surgery,the S100-β protein level of the patients in the observation group was(1.45±1.09)μg·L-1 and the NSE level was(13.20±4.06)μg·L-1,which were lower than those of(3.22±1.32)μg·L-1 and(16.95±3.96)μg·L-1,in the control(t=3.989,P=0.012,t=2.463,P=0.012).The observation group's time of mechanical ventilation,time of admission to the intensive care unit,and risk of rebleeding at 3 months postoperatively were(5.76±2.21)d,(7.25±2.41)d,and 3(5.00%),respectively,which were lower than those of the control((7.33±2.84)d,(9.92±2.51)d,10(16.67%))(t=3.379,5.944,χ2=4.231,all P＜0.05).Following surgery,the observation cohort exhibited reduced CPOT and RASS ratings compared to the control cohort,with these disparities being statistically considerable(all P＜0.05).At 24 h postoperatively,the GCS score of the observation group was higher than that of the control(12.34±1.66 vs 8.21±2.80)(t=9.828,P＜0.05)but NIHSS score was lower in the observation group than in the control(15.05±2.84 vs 19.31±1.76)(t=9.876,P＜0.05).Conclusion The combination of remifentanil,propofol and cisatracurium besylate has clinical value after being applied to patients with severe cerebral hemorrhage for smoothing hemodynamics,reducing plasma S100-β and NSE levels and attenuating brain damage.
Severe cerebral hemorrhageRemifentanilPropofolCisatracurium besylateBrain damageHemodynamics
万方数据
维普
