2018Zhonghua mazuixue zazhiRequires access

Effects of different anesthetics on recovery of neurological function after intracranial aneurysm embolization

Mingming Han, Xiang Huang, Chaoliang Tang, Danjun Lu, Mingyu Zhai, Huaming Zhang, Fang Kang, Juan Li

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Abstract

Objective To compare the effects of different anesthetics on the recovery of neurological function after intracranial aneurysm embolization. Methods One hundred patients of both sexes with aneurysmal subarachnoid hemorrhage, aged more than 18 yr, with body mass index of 18.5-24.0 kg/m2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ and WFNS grade Ⅰ-Ⅳ, with the thickness of subarachnoid hemorrhage more than 4 cm, were divided into 2 groups (n=50 each) using a random number table: propofol group (group P) and sevoflurane group (group S). After anesthesia induction, group P received intravenous infusion of propofol 100-300 μg·kg-1·min-1, while the end-tidal sevoflurane concentration was maintained at 1.4%-3.5% in group S. Immediately before induction (T0), immediately after the end of induction (T1), immediately after successful embolization of aneurysm (T2) and at 1, 2, 3 and 5 days after surgery (T3-6), central venous blood samples were collected for determination of plasma neuron-specific enolase and S100β protein concentrations by enzyme-linked immunosorbent assay.The development of postoperative cerebral vasospasm and delayed ischemic neurological deficit was recorded.The patients were followed up, and the Glasgow outcome score and occurrence of newly developed cerebral infarction were recorded within 6 months after surgery. Results There was no significant difference in the concentrations of plasma neuron-specific enolase and S100β protein at each time point, incidence of postoperative cerebral vasospasm and delayed ischemic neurological deficit, or Glasgow outcome score and incidence of newly developed cerebral infarction within 6 months after surgery between two groups (P>0.05). Conclusion Propofol and sevoflurane exert no effect on the recovery of neurological function after intracranial aneurysm embolization. Key words: Anesthetics; Recovery of function; Intracranial aneurysm; Embolization, therapeutic

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Objective To compare the effects of different anesthetics on the recovery of neurological function after intracranial aneurysm embolization. Methods One hundred patients of both sexes with aneurysmal subarachnoid hemorrhage, aged more than 18 yr, with body mass index of 18.5-24.0 kg/m2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ and WFNS grade Ⅰ-Ⅳ, with the thickness of subarachnoid hemorrhage more than 4 cm, were divided into 2 groups (n=50 each) using a random number table: propofol group (group P) and sevoflurane group (group S). After anesthesia induction, group P received intravenous infusion of propofol 100-300 μg·kg-1·min-1, while the end-tidal sevoflurane concentration was maintained at 1.4%-3.5% in group S. Immediately before induction (T0), immediately after the end of induction (T1), immediately after successful embolization of aneurysm (T2) and at 1, 2, 3 and 5 days after surgery (T3-6), central venous blood samples were collected for determination of plasma neuron-specific enolase and S100β protein concentrations by enzyme-linked immunosorbent assay.The development of postoperative cerebral vasospasm and delayed ischemic neurological deficit was recorded.The patients were followed up, and the Glasgow outcome score and occurrence of newly developed cerebral infarction were recorded within 6 months after surgery. Results There was no significant difference in the concentrations of plasma neuron-specific enolase and S100β protein at each time point, incidence of postoperative cerebral vasospasm and delayed ischemic neurological deficit, or Glasgow outcome score and incidence of newly developed cerebral infarction within 6 months after surgery between two groups (P>0.05). Conclusion Propofol and sevoflurane exert no effect on the recovery of neurological function after intracranial aneurysm embolization. Key words: Anesthetics; Recovery of function; Intracranial aneurysm; Embolization, therapeutic

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Available abstract

Objective To compare the effects of different anesthetics on the recovery of neurological function after intracranial aneurysm embolization. Methods One hundred patients of both sexes with aneurysmal subarachnoid hemorrhage, aged more than 18 yr, with body mass index of 18.5-24.0 kg/m2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ and WFNS grade Ⅰ-Ⅳ, with the thickness of subarachnoid hemorrhage more than 4 cm, were divided into 2 groups (n=50 each) using a random number table: propofol group (group P) and sevoflurane group (group S). After anesthesia induction, group P received intravenous infusion of propofol 100-300 μg·kg-1·min-1, while the end-tidal sevoflurane concentration was maintained at 1.4%-3.5% in group S. Immediately before induction (T0), immediately after the end of induction (T1), immediately after successful embolization of aneurysm (T2) and at 1, 2, 3 and 5 days after surgery (T3-6), central venous blood samples were collected for determination of plasma neuron-specific enolase and S100β protein concentrations by enzyme-linked immunosorbent assay.The development of postoperative cerebral vasospasm and delayed ischemic neurological deficit was recorded.The patients were followed up, and the Glasgow outcome score and occurrence of newly developed cerebral infarction were recorded within 6 months after surgery. Results There was no significant difference in the concentrations of plasma neuron-specific enolase and S100β protein at each time point, incidence of postoperative cerebral vasospasm and delayed ischemic neurological deficit, or Glasgow outcome score and incidence of newly developed cerebral infarction within 6 months after surgery between two groups (P>0.05). Conclusion Propofol and sevoflurane exert no effect on the recovery of neurological function after intracranial aneurysm embolization. Key words: Anesthetics; Recovery of function; Intracranial aneurysm; Embolization, therapeutic

Key concepts: Medicine, Anesthesia, Enolase, Subarachnoid hemorrhage, Glasgow Outcome Scale, Propofol, Aneurysm, Cerebral vasospasm

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