Propofol and sevoflurane combined with remifentanil on the pain index, inflammatory factors and postoperative cognitive function of spine fracture patients

Zhao, Yu; Zhang, Hongqi

doi:10.3892/etm.2018.5898

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…In clinics, sedative hypnotics and opioid narcotic analgesics are often used in anesthesia induction and maintenance [ 15 ]. When two or more drugs are used simultaneously or successively, the drug interaction may occur by modulating the drug action site, competitively binding with the receptor, or affecting the receptor's sensitivity to another drug, that is, synergistic, additive, or antagonistic action [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Remimazolam Besylate Combined with Alfentanil in Painless Gastroscopy: A Randomized, Single-Blind, Parallel Controlled Study

Chen

Ren

et al. 2022

Contrast Media & Molecular Imaging

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Background. The efficacy and adverse reactions of remimazolam besylate (RB) in combination with alfentanil in patients with painless gastroscopy remain unclear. Objective. The aim of the study is to observe the efficacy and adverse reactions of RB in combination with alfentanil in patients with painless gastroscopy RB. Methods. All patients were randomly divided into two groups: RB combined with the alfentanil group (research group) and propofol combined with the alfentanil group (control group). After full oxygen inhalation and electrocardiographic monitoring, the research group was given 10 μg/Kg alfentanil + RB 0.2 mg/kg intravenously, and the control group was given 10 μg/Kg alfentanil + propofol 1.5 mg/kg. If there is a clinical need, the research group was given 2.5 mg/additional RB, whereas the control group was treated with an additional 0.5 mg/kg propofol. Main outcome measures were as follows: The vital endpoints including diachronic changes in heart rate (HR), blood pressure (BP), respiratory rate (RR), blood oxygen saturation (SPO2), end-expiratory carbon dioxide (etCO2), IPI, modified observer’s assessment of alert/sedation (MOAA/S), time-related endpoints, perioperative adverse events, endoscopy, and anesthesiologist satisfaction, and 24-hour follow-up of adverse reactions, IPI scores, and satisfaction were recorded. Results. The HR and BP of the patients in the research group and the control group decreased, with a greater decrease in the control group, and the difference was statistically significant ( p < 0.05). The values of RR, PETCO2, and IPI in the research group and the control group decreased to the lowest at 2–3 min but the decrease in the control group was more significant. Furthermore, there was no significant difference in the time from the completion of administration to 4 minutes of IPI and the total examination time, but the awakening time in the research group was slightly longer than that in the control group, and the difference was statistically significant ( p < 0.05). The incidences of respiratory depression and hypotension during the operation were shown to be markedly smaller in the investigation relative to the control team, and the difference was statistically significant ( p < 0.05), whereas the occurrence of cough, movements, and singultus was more common in the investigations, and the difference was statistically significant ( p < 0.05). The results of the 24-hour follow-up showed that the adverse reactions such as nausea, dizziness, fatigue, abdominal pain, and abdominal distension were much less frequent in the study team, and the difference was statistically significant ( p < 0.05), and the patient satisfaction was higher than in the control group, and the difference was statistically significant ( p < 0.05). The regression results showed that age, sedative, and total dose of analgesia had significant effects on the results, and the covariance coefficient of sedative was 1.57 of IPI score in the research group higher than that of the control group. Conclusions. RB combined with alfentanil can provide safe and effective sedation for patients undergoing painless gastroscopy. Compared with propofol, RB and alfentanil for injection can avoid large hemodynamic fluctuations and deep sedation, and have fewer adverse reactions. However, the cases involved in this study are all from a single-center data, which requires further multicenter research and conformation.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Remimazolam Besylate Combined with Alfentanil in Painless Gastroscopy: A Randomized, Single-Blind, Parallel Controlled Study

Chen

Ren

et al. 2022

Contrast Media & Molecular Imaging

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“…With the development of the economy and the improvement of people's living standards, people's eating habits and structure have also changed with the aging of the population. The prevalence and mortality of cancer in China has increased year by year [1]. Surgery is still one of the best ways to cure tumors.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Effects of Propofol or Sevoflurane Combined with Remifentanil on Stress Response, Inflammatory Factors and Cerebral Oxygen Metabolism in Patients Undergoing Radical Esophagectomy

2022

IJHPM

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Clinical studies have shown that reducing the stress response and catabolism in the perioperative period and strengthening perioperative nutritional support can help to improve the surgical outcome and promote postoperative recovery. However, there are few studies on the effects of general anesthesia maintenance drugs on the catabolism and nutritional status of patients undergoing surgery. Based on the above background, the purpose of this paper is to compare the effects of propofol or sevoflurane combined with remifentanil on stress response, inflammatory factors and cerebral oxygen metabolism in patients undergoing radical resection of esophageal cancer. 120 patients with elective esophageal cancer who underwent radical surgery from September 2016 to September 9, 2018 were randomly divided into group A and group B, with 60 cases in each group. Group A was given anesthesia with propofol and remifentanil, and group B was given anesthesia with sevoflurane plus remifentanil. Peripheral blood was measured before and after induction of anesthesia (T0), immediately after surgery (T1), and 12 hours after surgery (T2). Comparison of stress response indicators (cortisol (COR), adrenaline (NE), adrenaline (NA)), inflammatory factors [IL-8 (priming), interleukin-6 (IL-6), tumor necrosis (TNF) -α)]) and cerebral oxygen metabolism index [(intracervical venous blood oxygen saturation (SjvO 2 ), internal jugular venous oxygen partial pressure (PjvO 2 ), arterial oxygen saturation (SaO 2 ), arterial oxygen partial pressure (PaO 2 ))] difference. The levels of COR, NE, NA, IL-8, IL-6 and TNF-α in T1 and T2 peripheral blood were higher than those in T0, but in group A, COR, NE, NA, IL-8, IL-6 and TNF were observed. -α was significantly lower than group B (P < 0.05). The SjvO 2 , PjvO 2 , SaO 2 and PaO 2 of T1 and T2 in the two groups were lower than T0, but the SjvO 2 , PjvO 2 , SaO 2 and PaO 2 in group A were significantly lower than those in group B (P < 0.05). Compared with sevoflurane combined with remifentanil anesthesia, propofol combined with remifentanil anesthesia is more conducive to the stress response, reduction of inflammatory factors and improvement of cerebral oxygen metabolism in patients with radical esophageal cancer.

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Forkhead Box O1-p21 Mediates Macrophage Polarization in Postoperative Cognitive Dysfunction Induced by Sevoflurane

Wang

Ren

2020

CNR

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Purpose: The current study was conducted in order to investigate the role of Forkhead box O1 and p21-mediated macrophage polarization in postoperative cognitive dysfunction induced by sevoflurane. Methods: There involved a total of 30 healthy mice that were randomly divided into two groups: control group (without any treatment) and anaesthesia group (treated with sevoflurane inhalation). The effects of sevoflurane on cognitive function (memory) in mice were studied by trace fear conditioned reflex, and the effects of systemic inflammation and behavior after operation were measured by enzyme-linked immunosorbent assay (ELISA), the concentrations of CD163 and tumor necrosis factor-α (TNF-α) were measured. The expression of macrophage phenotype was observed by immunofluorescence staining, the expression levels of M1 and M2 markers mRNA were detected by real-time fluorescence quantitative PCR (RT-PCR), and the expression levels of FoxO1 and p21 were analyzed by immunoblotting (Western blot). Results: Compared with the control group, the freezing time in the anesthesia group was lower than that in the control group (P<0.01), indicating that sevoflurane anesthesia led to the decrease of cognitive ability. The blood concentrations of CD163 and TNF-α increased significantly at 24 h after the operation with sevoflurane anesthesia (P<0.05). Fluorescence microscopic observation showed that M2 was the main type of macrophages in normal tissues, while M1 and M2 phenotypes were highly expressed in sevoflurane anesthetized tissues at the same time, especially in M1 phenotypes (P<0.01). The polarization of macrophages in the anesthetic group showed the high level of M1 mRNA, and the expression levels of TNF-α, monocyte chemotactic protein 1(MCP-1) and Interleukin-6 (IL-6)mRNA in the anesthetic group were significantly higher than those in the control group (P<0.05). The expression levels of M2 mRNA such as transforming growth factor-β (TGF-β) and IL-10 were significantly lower than those in the control group (P<0.05). Compared with the control group, the expression of FoxO1 and p21 protein in the anesthesia group was significantly lower than that in the control group with a significant statistical difference (P<0.01). Conclusion: This study offers a theoretical basis and insight for further understanding of the prevention and treatment of cognitive dysfunction induced by anesthetic drugs.

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Propofol and sevoflurane combined with remifentanil on the pain index, inflammatory factors and postoperative cognitive function of spine fracture patients

Cited by 5 publications

References 19 publications

Efficacy and Safety of Remimazolam Besylate Combined with Alfentanil in Painless Gastroscopy: A Randomized, Single-Blind, Parallel Controlled Study

Efficacy and Safety of Remimazolam Besylate Combined with Alfentanil in Painless Gastroscopy: A Randomized, Single-Blind, Parallel Controlled Study

Comparison of Effects of Propofol or Sevoflurane Combined with Remifentanil on Stress Response, Inflammatory Factors and Cerebral Oxygen Metabolism in Patients Undergoing Radical Esophagectomy

Forkhead Box O1-p21 Mediates Macrophage Polarization in Postoperative Cognitive Dysfunction Induced by Sevoflurane

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