The Effects Of The Sevoflurane On Haemodynamic Variation And Propofol Target Plasma Concentration In The Neurosurgery On General Anesthesia

Objective: To evaluate the influence of sevoflurane and plasma target-controlledinfusion propofol on the target concentration of propofol and hemodynamics.Methods: Twenty six patients with neurosurgery intracranial space-occupyingcraniotomy in first affiliated hospital of Dalian Medical University. The patients wererandomly divided into the total intravenous anesthesia group (p group) and inhalationanesthesia group (s group), each group contained13cases. The induction andmaintenance of anesthesia: at the beginning, the infusion of Propofol was taken in atarget-controlled way, The propofol target plasma concentration of P group was set to3μg/ml. The propofol target plasma concentration of S group was set to1.5μg/ml. Theinduction time of P group is2minutes and S group is5minutes. Then, the infusion ofmidazolam0.05mg/kg, sufentanil0.6-0.8μg/kg and cis acid atracurium0.2mg/k weretaken in an intravenous administration way.3%of sevoflurane was inhaled in S group.Respiratory mechanical ventilation was taken after endotracheal intubation. The tidalvolume of8ml/kg, inspiratory to expiratory ratio of1:2and the respiratory rate of12beats/min were set. At the same time, End-expiratory CO2partial pressure (PETCO2)and concentration of sevoflurane were monitored. Two groups of propofol targetconcentration remained unchanged in both groups in the process of operation.Additional cis acid Atracurium was timely added to maintain muscle relaxants. Thedepth of anesthesia the p group was deepened by sufentanil0.1μg/kg, In the s group, theconcentration of sevoflurane was timely adjusted to deepen the depth of anesthesia.When before induction (T1), immediately before intubation (T2), immediately afterintubation (T3), skin cutting (T4), craniotomy (T5), cutting dural (T6), and extubation(T7), the systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR)，were respectively recorded, either the dosage ofmidazolam, sufentanil, propofol, cis acid atracurium and sevoflurane. In the end,extubation time, recovery time, VAS score and postoperative untoward reaction wererecorded.Results: The SBP, DBP, MAP, HR were no significantly different between thesetwo groups in different time points (P>0.05). The SBP, DBP, HR in both groupsdecreased significantly (P <0.05) at the T2time point in contrast to the time point T2.The recovery time and extubation time of P group were significantly shorter than the Sgroup’s (P <0.01). The occurrence rate of postoperative untoward reaction in S groupobviously higher than that in the P group (P <0.05).The VAS score was no differencestatistically significant in both groups (P>0.05).Conclusions:1.0%-1.2%of Sevoflurane can reduce concentration of propofoltarget plasma to50%on general anesthesia,it has no significantly influence on Variationof Haemodynamics in the Neurosurgery. In contrast to the Sevoflurane, However, thetotal intravenous anesthesia with propofol, which have the advantages of rapid effect,rapid anesthesia recovery, easy-controlled depth of anesthesia and few postoperativeuntoward reactions, is more suitable for the neurosurgery.