异丙酚与七氟醚对儿童 Moyamoya 病脑氧饱和度的影响。近红外光谱研究。

J R Seshan, I Kapoor, H Prabhakar, C Mahajan
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引用次数: 0

摘要

引言和目的:莫亚莫亚病(MMD)手术中的麻醉对大脑生理有不同的影响。七氟醚和丙泊酚都有保护大脑的作用,尽管机制不同。我们使用近红外光谱(NIRS)观察了七氟醚和异丙酚对接受MMD手术的儿科患者rSO2的影响:我们纳入了 1 至 18 岁接受 MMD 手术的 ASA I 级儿科患者,为期 1 年(从 2018 年 4 月 1 日至 2019 年 4 月 1 日)。患者被随机分为 2 组:S组(七氟烷)和P组(异丙酚)。在 5 个时间点记录 NIRS 值:T1(基线)、T2(预吸氧后)、T3(诱导后)、T4(手术结束)、T5(拔管后)。组内比较采用单因素方差分析,组间比较采用带 Bonferroni 校正的双因素重复测量方差分析。P 值 结果:本研究共纳入 20 名患者。平均年龄为 10.5 ± 4.3 岁。右半球和左半球的基线 rSO2 平均值分别为 78.35 ± 10.58 和 77.95 ± 8.81。两组患者的 rSO2 值在基线和麻醉诱导期间均有所上升,在手术结束时略有下降。组间分析显示,两组的rSO2值没有统计学意义上的显著变化:结论:七氟烷和异丙酚都能在接受MMD手术的儿童中维持足够的rSO2水平:CTRI/2018/04/013229注册于2018年4月12日。
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Effect of propofol versus sevoflurane on cerebral oxygenation in childhood Moyamoya disease. A near infrared spectroscopy study.

Introduction and objectives: Anaesthesia during surgery for moyamoya disease (MMD) has different effects on cerebral physiology. Both sevoflurane and propofol have cerebral protective effects, albeit with different mechanisms. We used near infrared spectroscopy (NIRS) to observe the effect of sevoflurane and propofol on rSO2 in paediatric patients undergoing MMD surgery.

Materials and methods: We included paediatric patients ASA grade I aged between 1 and 18 years undergoing surgery for MMD over a period of 1 year (from 1 April 2018 to 1 April 2019). Patients were randomized to 2 groups: Group S (sevoflurane) and Group P (propofol). NIRS values were recorded at 5 time points: T1 (baseline) T2 (after preoxygenation), T3 (after induction), T4 (end of surgery), T5 (after extubation). One-way ANOVA was used for intra-group comparisons and two-way repeated measures ANOVA with Bonferroni correction were used for inter-group comparisons. P value <0.05 was considered significant.

Results: A total of 20 patients were included in the study. The average age was 10.5 ± 4.3 years. The mean baseline rSO2 was 78.35 ± 10.58 and 77.95 ± 8.81 in the right and left hemispheres, respectively. In both groups, rSO2 values increased between baseline and anaesthesia induction and fell slightly at the end of surgery. The inter-group analysis showed no statistically significant change between rSO2 values.

Conclusion: Both sevoflurane and propofol maintain adequate rSO2 levels in children undergoing surgery for MMD.

Clinical trial registration number: CTRI/2018/04/013229 registered on 12.04.2018.

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