Effects of remifentanil combined with propofol anesthesia on IL-1β, IL-6, TNF-α and hemodynamics in patients with brain surgery

摘要

Objective: To observe clinical application of remifentanil combined with propofol anesthesiaand fentanyl combined with propofol anesthesia in patients with brain surgery, and analyzethe change of hemodynamics and serum IL-1β, IL-6 and TNF-α before and after operation.Methods: A total of 90 cases of patients with brain surgery were randomly divided intocontrol group and observation group according to lottery. The control group was givenfentanyl combined with propofol anesthesia and the observation group was given remifentanilcombined with propofol anesthesia, other combined anesthetic drug was same in both groups.Hemodynamics of all subjects before tracheal intubation (T1), after tracheal intubation (T2),when shin incision (T3) and when extubation (T4) and serum IL-1β, IL-6 and TNF-α beforeand after surgery 24 hours were measured. Results: There was no significant difference inhemodynamic indexes of all patients in both groups at T1. At T2, T3 and T4, heart rate (HR) andmean arterial pressure (MAP) of the observation group were significantly lower than those inthe control group at same period, however blood oxygen saturation (SpO2) was higher thanthat in the control group at corresponding period, it was significant difference. At T2, T3 andT4, observation indexes HR and MAP of the control group were significantly higher than thoseat T1, while SpO2 was significantly lower than T1, there was statistical significant difference.While there was no significant difference in HR, MAP and SpO2 in observation group at T1,T2, T3 and T4. There was no significant differences in serum IL-1β, IL-6 and TNF-α levelsbetween the control group and the observation group before surgery. After 24 h of operation,the levels of IL-1β, IL-6 and TNF-α in both groups were higher than those before operation;Moreover levels of IL-1β, IL-6 and TNF-α in observation group were significantly lowerthan those in the control group at same period after 24 h of operation it was statisticalsignificant difference. Conclusion: Remifentanil combined with propofol anesthesia was ableto maintain hemodynamic stability and reduce concentration of serum inflammatory factors,which was one of the potential effective anesthetic compounds.