Effects of Sevoflurane and Propofol on Neurological Recovery of Traumatic Brain Injury Patients in the Early Postoperative Stage: A Retrospective Cohort Study  

作　　者：Bei Wu Wan-Qing Song Jin-Qian Dong Hong-Li Yue Yu Lu Yun Yu Shu-Yu Hao Bai-Yun Liu Wei-Hua Cui 

机构地区：[1]Department of Anesthesiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China [2]Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China

出　　处：《Chinese Medical Sciences Journal》2023年第2期97-108,共12页中国医学科学杂志（英文版）

基　　金：Beijing Natural Sciences Foundation(7173255);Beijing Municipal Administration of Hospital Incubating Program(PX2019019).

摘　　要：Objective To investigate the effects of propofol and sevoflurane on neurological recovery of traumatic brain injury(TBI)patients in the early postoperative stage.Methods We retrospectively analyzed the clinical data of TBI patients who underwent craniotomy or decompressive craniectomy.Generalized additive mixed model(GAMM)was used to analyze effects of propofol and sevoflurane on Glasgow Coma Scale(GCS)on postoperative days 1,3,and 7.Multivariate regression analysis was used to analyze effects of the two anesthetics on Glasgow Outcome Scale(GOS)at discharge.Results A total of 340 TBI patients were enrolled in this study.There were 110 TBI patients who underwent craniotomy including 75 in the propofol group and 35 in the sevoflurane group,and 134 patients who underwent decompressive craniectomy including 63 in the propofol group and 71 in the sevoflurane group.It showed no significant difference in GCS at admission between the propofol and the sevoflurane groups among craniotomy patients(β=0.75,95%CI:-0.55 to 2.05,P=0.260).However,elevation in GCS from baseline was 1.73 points(95%CI:-2.81 to-0.66,P=0.002)less in the sevoflurane group than that in the propofol group on postoperative day 1,2.03 points(95%CI:-3.14 to-0.91,P 0.001)less on day 3,and 1.31 points(95%CI:-2.43 to-0.19,P=0.022)less on day 7.The risk of unfavorable GOS(GOS 1,2,and 3)at discharge was higher in the sevoflurane group(OR=4.93,95%CI:1.05 to 23.03,P=0.043).No significant difference was observed among two-group decompressive craniectomy patients in GCS and GOS.Conclusions Compared to propofol,sevoflurane was associated with worse neurological recovery during the hospital stay in TBI patients undergoing craniotomy.This difference was not detected in TBI patients undergoing decompressive craniectomy.

关 键 词：Glasgow Coma Scale Glasgow Outcome Scale PROPOFOL SEVOFLURANE traumatic brain injury 

分 类 号：R651.15[医药卫生—外科学]