Application of sevoflurane combined with remifentanil in interventional thrombectomy of ischemic stroke patients and its influence on neurological and cognitive function
10.3760/cma.j.cn115455-20230911-00242
- VernacularTitle:七氟烷复合瑞芬太尼在缺血性脑卒中患者介入取栓术中的应用及对神经功能、认知功能的影响
- Author:
Caiqing CHENG
1
;
Ju DONG
1
;
Yingchun YANG
1
Author Information
1. 西宁第三人民医院麻醉科，西宁 810017
- Publication Type:Journal Article
- Keywords:
Brain infarction;
Anesthesia, intravenous;
Remifentanil;
Sevoflurane;
Interventional thrombectomy
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(2):177-181
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application value of sevoflurane combined with remifentanil in interventional thrombectomy of ischemic stroke patients and its influence on neurological and cognitive function.Methods:The clinical data of 84 patients with ischemic stroke treatment in the Xining Third People′s Hospital from September 2020 to September 2022 were selected retrospectively, and they were divided into the conventional group (42 cases) and experimental group (42 cases) according the treatment methods. Interventional thrombectomy was performed in both groups. Propofol combined with remifentanil was used in the conventional group, and sevoflurane combined with remifentanil was used in the experimental group. The excellent and good rate of anesthesia was compared between the two groups; the hemodynamic indexes before anesthesia induction (T 1), at the beginning of surgery (T 2), after thrombectomy and extubation (T 3) and at the end of surgery (T 4) were compared between the two groups; the brain injury indexes were compared before and 12, 24 and 48 h after surgery were compared between the two groups; the National Institutes of Health Stroke Scale (NIHSS) score, Simple Mental State Examination Scale (MMSE) score, postoperative cognitive dysfunction (POCD) and anesthesiation-related adverse reactions were compared between the two groups. Results:The excellent and good rate of anesthesia in the experimental group was higher than that in the conventional group:100.00% (42/42) vs. 83.33% (35/42), there was statistical difference ( χ2 = 5.61, P<0.05). The mean arterial pressure (MAP), heart rate (HR), and pulse oxygen saturation (SpO 2) in the two groups at T 2, T 3 and T 4 were higher than those at T 1 ( P<0.05); the MAP, HR and SpO 2 in the experimental group at T 2, T 3 and T 4 were lower than those in the conventional group ( P<0.05). The serum neuron-specific enolase (NSE) and S100β protein were significantly increased at 12 and 24 h after surgery in both groups ( P<0.05); serum NSE and S100β proteins in the experimental group at 12, 24 and 48 h were lower than those in the conventional group: (30.12 ± 4.26) μg/L vs. (35.64 ± 5.70) μg/L, (22.69 ± 4.01) μg/L vs. (26.81 ± 5.53) μg/L, (18.71 ± 2.92)μg/L vs. (21.34 ± 4.02) μg/L, (1.19 ± 0.20) μg/L vs. (1.37 ± 0.24) μg/L, (0.96 ± 0.13) μg/L vs. (1.13 ± 0.16) μg/L, (0.80 ± 0.11) μg/L vs. (0.94 ± 0.15) μg/L, there were statistical differences ( P<0.05). The NIHSS score was significantly higher and the MMSE score was significantly lower in both groups at 12 and 24 h after surgery ( P<0.05); the NIHSS score and MMSE score in both groups recovered to preoperative level at 48 h after the operation ( P>0.05). The NIHSS score in the experimental group at 12 and 24 h after surgery was lower than that in the conventional group, and the MMSE score was higher than that in the conventional group ( P<0.05). The incidence of anesthesia-related adverse reactions in the experimental groups was lower than that in the control group: 4.76%(2/42) vs. 21.43%(9/42); and the incidence of POCD was lower than that in the conventional group: 19.05%(8/42) vs. 2.38%(1/42), there were statistical differences ( χ2 = 5.13, 4.48, P<0.05). Conclusions:Sevoflurane combined with remifentanil has a significant anesthetic effect in interventional thrombectomy of ischemic stroke patients, which can stabilize hemodynamics, reduce the degree of brain injury, promote cognitive function recovery, and reduce POCD and adverse reactions.
