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

Yu Zhao, Hongqi Zhang, Yu Zhao, Hongqi Zhang

Abstract

The effects of propofol vs. sevoflurane combined with remifentanil on the pain index, inflammatory factors and postoperative cognitive function in spine fracture patients were studied and analyzed. A total of 62 patients with vertebral fracture were randomly divided into the propofol group (P group, n=41) and the sevoflurane group (S group, n=41). P group used induction anesthesia with propofol, and maintained anesthesia via intravenous injection of remifentanil. While patients in S group received induction anesthesia with sevoflurane, and also remifentanil as the maintained anesthesia. Results showed that extubation time, eye-opening time and response time of P group were lower than S group (p<0.05). The VAS score 48 h after surgery in P group was significantly lower than the S group (p<0.05). Levels of IL-6, IL-1β, ICAM-1 and MMP-9 in serum in P group were lower than those in S group (p<0.05). Mini-mental state examination (MMSE) score 24 h after surgery in P group was higher than that in S group (p<0.01). Compared with sevoflurane anesthesia, propofol combined with remifentanil anesthesia on spine fracture patients can significantly decrease the pain index and inflammatory reaction, shorten the postoperative recovery time.

Keywords: propofol; sevoflurane; spine fracture patients.

Figures

Figure 1.
Figure 1.
Evaluation of recovery time after operation. The extubation time, eye-opening time and response time of patients in Group P are significantly shorter than those in Group S. *p

Figure 2.

VAS scores of patients in…

Figure 2.

VAS scores of patients in two groups. There is no statistically significant difference…

Figure 2.
VAS scores of patients in two groups. There is no statistically significant difference in VAS score between the groups of patients at 24 h after operation, and the VAS score of patients in Group P at 48 h after operation is significantly lower than that in Group S. **p

Figure 3.

Comparison of inflammatory response. (A)…

Figure 3.

Comparison of inflammatory response. (A) Serum IL-6 concentration; (B) serum IL-1β concentration; (C)…

Figure 3.
Comparison of inflammatory response. (A) Serum IL-6 concentration; (B) serum IL-1β concentration; (C) serum ICAM-1 concentration; (D) serum MMP-9 concentration. The levels of serum IL-6, IL-1β, ICAM-1 and MMP-9 in patients in the groups have no statistically significant differences before and after operation; the levels of serum IL-6, IL-1β, ICAM-1 and MMP-9 in patients in Group P at 24 h after operation are significantly lower than those in Group S. **p

Figure 4.

MMSE scores. There are no…

Figure 4.

MMSE scores. There are no statistically significant differences in the MMSE scores between…

Figure 4.
MMSE scores. There are no statistically significant differences in the MMSE scores between two groups of patients before operation and at 48 h after operation; at 24 h after operation, the MMSE score of patients in Group P is significantly higher than that in Group S. *p

Figure 5.

Serum S100β concentrations. There is…

Figure 5.

Serum S100β concentrations. There is no statistically significant difference in the serum S100β…

Figure 5.
Serum S100β concentrations. There is no statistically significant difference in the serum S100β concentration between two groups of patients before operation; at 24 and 48 h after operation, the serum S100β concentrations of patients in Group P are significantly lower than those in Group S. *p

Figure 6.

Postoperative evaluation of physiological indexes.…

Figure 6.

Postoperative evaluation of physiological indexes. There are no statistically significant differences in MAP…

Figure 6.
Postoperative evaluation of physiological indexes. There are no statistically significant differences in MAP and HR at 24 and 48 h after operation between the two groups of patients.
Similar articles
Cited by
References
    1. Health Quality Ontario, corp-author. Vertebral augmentation involving vertebroplasty or kyphoplasty for cancer-related vertebral compression fractures: A systematic review. Ont Health Technol Assess Ser. 2016;16:1–202. - PMC - PubMed
    1. Yu WY, Lou C, Liu FJ, He DW. Clinical efficacy of one stage posterior debridement joint graft fixation for lumbar vertebral fractures in spinal tuberculosis patients with compression. Eur Rev Med Pharmacol Sci. 2016;20:3161–3167. - PubMed
    1. Malgo F, Hamdy NAT, Ticheler CHJM, Smit F, Kroon HM, Rabelink TJ, Dekkers OM, Appelman-Dijkstra NM. Value and potential limitations of vertebral fracture assessment (VFA) compared to conventional spine radiography: Experience from a fracture liaison service (FLS) and a meta-analysis. Osteoporos Int. 2017;28:2955–2965. doi: 10.1007/s00198-017-4137-6. - DOI - PMC - PubMed
    1. Cawthon PM, Schousboe JT, Harrison SL, Ensrud KE, Black D, Cauley JA, Cummings SR, Le Blanc ES, Laughlin GA, Nielson CM, et al. Osteoporotic fractures in men (MrOS) study research group: Sex hormones, sex hormone binding globulin, and vertebral fractures in older men. Bone. 2016;84:271–278. doi: 10.1016/j.bone.2016.01.009. - DOI - PMC - PubMed
    1. Cao J, Xie H, Sun Y, Zhu J, Ying M, Qiao S, Shao Q, Wu H, Wang C. Sevoflurane post-conditioning reduces rat myocardial ischemia reperfusion injury through an increase in NOS and a decrease in phopshorylated NHE1 levels. Int J Mol Med. 2015;36:1529–1537. doi: 10.3892/ijmm.2015.2366. - DOI - PMC - PubMed
Show all 20 references
Related information
Full text links [x]
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM

NCBI Literature Resources

MeSH PMC Bookshelf Disclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

Follow NCBI
Figure 2.
Figure 2.
VAS scores of patients in two groups. There is no statistically significant difference in VAS score between the groups of patients at 24 h after operation, and the VAS score of patients in Group P at 48 h after operation is significantly lower than that in Group S. **p

Figure 3.

Comparison of inflammatory response. (A)…

Figure 3.

Comparison of inflammatory response. (A) Serum IL-6 concentration; (B) serum IL-1β concentration; (C)…

Figure 3.
Comparison of inflammatory response. (A) Serum IL-6 concentration; (B) serum IL-1β concentration; (C) serum ICAM-1 concentration; (D) serum MMP-9 concentration. The levels of serum IL-6, IL-1β, ICAM-1 and MMP-9 in patients in the groups have no statistically significant differences before and after operation; the levels of serum IL-6, IL-1β, ICAM-1 and MMP-9 in patients in Group P at 24 h after operation are significantly lower than those in Group S. **p

Figure 4.

MMSE scores. There are no…

Figure 4.

MMSE scores. There are no statistically significant differences in the MMSE scores between…

Figure 4.
MMSE scores. There are no statistically significant differences in the MMSE scores between two groups of patients before operation and at 48 h after operation; at 24 h after operation, the MMSE score of patients in Group P is significantly higher than that in Group S. *p

Figure 5.

Serum S100β concentrations. There is…

Figure 5.

Serum S100β concentrations. There is no statistically significant difference in the serum S100β…

Figure 5.
Serum S100β concentrations. There is no statistically significant difference in the serum S100β concentration between two groups of patients before operation; at 24 and 48 h after operation, the serum S100β concentrations of patients in Group P are significantly lower than those in Group S. *p

Figure 6.

Postoperative evaluation of physiological indexes.…

Figure 6.

Postoperative evaluation of physiological indexes. There are no statistically significant differences in MAP…

Figure 6.
Postoperative evaluation of physiological indexes. There are no statistically significant differences in MAP and HR at 24 and 48 h after operation between the two groups of patients.
Similar articles
Cited by
References
    1. Health Quality Ontario, corp-author. Vertebral augmentation involving vertebroplasty or kyphoplasty for cancer-related vertebral compression fractures: A systematic review. Ont Health Technol Assess Ser. 2016;16:1–202. - PMC - PubMed
    1. Yu WY, Lou C, Liu FJ, He DW. Clinical efficacy of one stage posterior debridement joint graft fixation for lumbar vertebral fractures in spinal tuberculosis patients with compression. Eur Rev Med Pharmacol Sci. 2016;20:3161–3167. - PubMed
    1. Malgo F, Hamdy NAT, Ticheler CHJM, Smit F, Kroon HM, Rabelink TJ, Dekkers OM, Appelman-Dijkstra NM. Value and potential limitations of vertebral fracture assessment (VFA) compared to conventional spine radiography: Experience from a fracture liaison service (FLS) and a meta-analysis. Osteoporos Int. 2017;28:2955–2965. doi: 10.1007/s00198-017-4137-6. - DOI - PMC - PubMed
    1. Cawthon PM, Schousboe JT, Harrison SL, Ensrud KE, Black D, Cauley JA, Cummings SR, Le Blanc ES, Laughlin GA, Nielson CM, et al. Osteoporotic fractures in men (MrOS) study research group: Sex hormones, sex hormone binding globulin, and vertebral fractures in older men. Bone. 2016;84:271–278. doi: 10.1016/j.bone.2016.01.009. - DOI - PMC - PubMed
    1. Cao J, Xie H, Sun Y, Zhu J, Ying M, Qiao S, Shao Q, Wu H, Wang C. Sevoflurane post-conditioning reduces rat myocardial ischemia reperfusion injury through an increase in NOS and a decrease in phopshorylated NHE1 levels. Int J Mol Med. 2015;36:1529–1537. doi: 10.3892/ijmm.2015.2366. - DOI - PMC - PubMed
Show all 20 references
Related information
Full text links [x]
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM

NCBI Literature Resources

MeSH PMC Bookshelf Disclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

Follow NCBI
Figure 3.
Figure 3.
Comparison of inflammatory response. (A) Serum IL-6 concentration; (B) serum IL-1β concentration; (C) serum ICAM-1 concentration; (D) serum MMP-9 concentration. The levels of serum IL-6, IL-1β, ICAM-1 and MMP-9 in patients in the groups have no statistically significant differences before and after operation; the levels of serum IL-6, IL-1β, ICAM-1 and MMP-9 in patients in Group P at 24 h after operation are significantly lower than those in Group S. **p

Figure 4.

MMSE scores. There are no…

Figure 4.

MMSE scores. There are no statistically significant differences in the MMSE scores between…

Figure 4.
MMSE scores. There are no statistically significant differences in the MMSE scores between two groups of patients before operation and at 48 h after operation; at 24 h after operation, the MMSE score of patients in Group P is significantly higher than that in Group S. *p

Figure 5.

Serum S100β concentrations. There is…

Figure 5.

Serum S100β concentrations. There is no statistically significant difference in the serum S100β…

Figure 5.
Serum S100β concentrations. There is no statistically significant difference in the serum S100β concentration between two groups of patients before operation; at 24 and 48 h after operation, the serum S100β concentrations of patients in Group P are significantly lower than those in Group S. *p

Figure 6.

Postoperative evaluation of physiological indexes.…

Figure 6.

Postoperative evaluation of physiological indexes. There are no statistically significant differences in MAP…

Figure 6.
Postoperative evaluation of physiological indexes. There are no statistically significant differences in MAP and HR at 24 and 48 h after operation between the two groups of patients.
Similar articles
Cited by
References
    1. Health Quality Ontario, corp-author. Vertebral augmentation involving vertebroplasty or kyphoplasty for cancer-related vertebral compression fractures: A systematic review. Ont Health Technol Assess Ser. 2016;16:1–202. - PMC - PubMed
    1. Yu WY, Lou C, Liu FJ, He DW. Clinical efficacy of one stage posterior debridement joint graft fixation for lumbar vertebral fractures in spinal tuberculosis patients with compression. Eur Rev Med Pharmacol Sci. 2016;20:3161–3167. - PubMed
    1. Malgo F, Hamdy NAT, Ticheler CHJM, Smit F, Kroon HM, Rabelink TJ, Dekkers OM, Appelman-Dijkstra NM. Value and potential limitations of vertebral fracture assessment (VFA) compared to conventional spine radiography: Experience from a fracture liaison service (FLS) and a meta-analysis. Osteoporos Int. 2017;28:2955–2965. doi: 10.1007/s00198-017-4137-6. - DOI - PMC - PubMed
    1. Cawthon PM, Schousboe JT, Harrison SL, Ensrud KE, Black D, Cauley JA, Cummings SR, Le Blanc ES, Laughlin GA, Nielson CM, et al. Osteoporotic fractures in men (MrOS) study research group: Sex hormones, sex hormone binding globulin, and vertebral fractures in older men. Bone. 2016;84:271–278. doi: 10.1016/j.bone.2016.01.009. - DOI - PMC - PubMed
    1. Cao J, Xie H, Sun Y, Zhu J, Ying M, Qiao S, Shao Q, Wu H, Wang C. Sevoflurane post-conditioning reduces rat myocardial ischemia reperfusion injury through an increase in NOS and a decrease in phopshorylated NHE1 levels. Int J Mol Med. 2015;36:1529–1537. doi: 10.3892/ijmm.2015.2366. - DOI - PMC - PubMed
Show all 20 references
Related information
Full text links [x]
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM

NCBI Literature Resources

MeSH PMC Bookshelf Disclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

Follow NCBI
Figure 4.
Figure 4.
MMSE scores. There are no statistically significant differences in the MMSE scores between two groups of patients before operation and at 48 h after operation; at 24 h after operation, the MMSE score of patients in Group P is significantly higher than that in Group S. *p

Figure 5.

Serum S100β concentrations. There is…

Figure 5.

Serum S100β concentrations. There is no statistically significant difference in the serum S100β…

Figure 5.
Serum S100β concentrations. There is no statistically significant difference in the serum S100β concentration between two groups of patients before operation; at 24 and 48 h after operation, the serum S100β concentrations of patients in Group P are significantly lower than those in Group S. *p

Figure 6.

Postoperative evaluation of physiological indexes.…

Figure 6.

Postoperative evaluation of physiological indexes. There are no statistically significant differences in MAP…

Figure 6.
Postoperative evaluation of physiological indexes. There are no statistically significant differences in MAP and HR at 24 and 48 h after operation between the two groups of patients.
Similar articles
Cited by
References
    1. Health Quality Ontario, corp-author. Vertebral augmentation involving vertebroplasty or kyphoplasty for cancer-related vertebral compression fractures: A systematic review. Ont Health Technol Assess Ser. 2016;16:1–202. - PMC - PubMed
    1. Yu WY, Lou C, Liu FJ, He DW. Clinical efficacy of one stage posterior debridement joint graft fixation for lumbar vertebral fractures in spinal tuberculosis patients with compression. Eur Rev Med Pharmacol Sci. 2016;20:3161–3167. - PubMed
    1. Malgo F, Hamdy NAT, Ticheler CHJM, Smit F, Kroon HM, Rabelink TJ, Dekkers OM, Appelman-Dijkstra NM. Value and potential limitations of vertebral fracture assessment (VFA) compared to conventional spine radiography: Experience from a fracture liaison service (FLS) and a meta-analysis. Osteoporos Int. 2017;28:2955–2965. doi: 10.1007/s00198-017-4137-6. - DOI - PMC - PubMed
    1. Cawthon PM, Schousboe JT, Harrison SL, Ensrud KE, Black D, Cauley JA, Cummings SR, Le Blanc ES, Laughlin GA, Nielson CM, et al. Osteoporotic fractures in men (MrOS) study research group: Sex hormones, sex hormone binding globulin, and vertebral fractures in older men. Bone. 2016;84:271–278. doi: 10.1016/j.bone.2016.01.009. - DOI - PMC - PubMed
    1. Cao J, Xie H, Sun Y, Zhu J, Ying M, Qiao S, Shao Q, Wu H, Wang C. Sevoflurane post-conditioning reduces rat myocardial ischemia reperfusion injury through an increase in NOS and a decrease in phopshorylated NHE1 levels. Int J Mol Med. 2015;36:1529–1537. doi: 10.3892/ijmm.2015.2366. - DOI - PMC - PubMed
Show all 20 references
Related information
Full text links [x]
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM
Figure 5.
Figure 5.
Serum S100β concentrations. There is no statistically significant difference in the serum S100β concentration between two groups of patients before operation; at 24 and 48 h after operation, the serum S100β concentrations of patients in Group P are significantly lower than those in Group S. *p

Figure 6.

Postoperative evaluation of physiological indexes.…

Figure 6.

Postoperative evaluation of physiological indexes. There are no statistically significant differences in MAP…

Figure 6.
Postoperative evaluation of physiological indexes. There are no statistically significant differences in MAP and HR at 24 and 48 h after operation between the two groups of patients.
Figure 6.
Figure 6.
Postoperative evaluation of physiological indexes. There are no statistically significant differences in MAP and HR at 24 and 48 h after operation between the two groups of patients.

References

    1. Health Quality Ontario, corp-author. Vertebral augmentation involving vertebroplasty or kyphoplasty for cancer-related vertebral compression fractures: A systematic review. Ont Health Technol Assess Ser. 2016;16:1–202.
    1. Yu WY, Lou C, Liu FJ, He DW. Clinical efficacy of one stage posterior debridement joint graft fixation for lumbar vertebral fractures in spinal tuberculosis patients with compression. Eur Rev Med Pharmacol Sci. 2016;20:3161–3167.
    1. Malgo F, Hamdy NAT, Ticheler CHJM, Smit F, Kroon HM, Rabelink TJ, Dekkers OM, Appelman-Dijkstra NM. Value and potential limitations of vertebral fracture assessment (VFA) compared to conventional spine radiography: Experience from a fracture liaison service (FLS) and a meta-analysis. Osteoporos Int. 2017;28:2955–2965. doi: 10.1007/s00198-017-4137-6.
    1. Cawthon PM, Schousboe JT, Harrison SL, Ensrud KE, Black D, Cauley JA, Cummings SR, Le Blanc ES, Laughlin GA, Nielson CM, et al. Osteoporotic fractures in men (MrOS) study research group: Sex hormones, sex hormone binding globulin, and vertebral fractures in older men. Bone. 2016;84:271–278. doi: 10.1016/j.bone.2016.01.009.
    1. Cao J, Xie H, Sun Y, Zhu J, Ying M, Qiao S, Shao Q, Wu H, Wang C. Sevoflurane post-conditioning reduces rat myocardial ischemia reperfusion injury through an increase in NOS and a decrease in phopshorylated NHE1 levels. Int J Mol Med. 2015;36:1529–1537. doi: 10.3892/ijmm.2015.2366.
    1. Zhou L, Wang Z, Zhou H, Liu T, Lu F, Wang S, Li J, Peng S, Zuo Z. Neonatal exposure to sevoflurane may not cause learning and memory deficits and behavioral abnormality in the childhood of Cynomolgus monkeys. Sci Rep. 2015;5:11145. doi: 10.1038/srep11145.
    1. De Conno E, Steurer MP, Wittlinger M, Zalunardo MP, Weder W, Schneiter D, Schimmer RC, Klaghofer R, Neff TA, Schmid ER, et al. Anesthetic-induced improvement of the inflammatory response to one-lung ventilation. Anesthesiology. 2009;110:1316–1326. doi: 10.1097/ALN.0b013e3181a10731.
    1. Visvabharathy L, Xayarath B, Weinberg G, Shilling RA, Freitag NE. Propofol increases host susceptibility to microbial infection by reducing subpopulations of mature immune effector cells at sites of infection. PLoS One. 2015;10:e0138043. doi: 10.1371/journal.pone.0138043.
    1. Katzman WB, Vittinghoff E, Kado DM, Lane NE, Ensrud KE, Shipp K. Thoracic kyphosis and rate of incident vertebral fractures: The fracture intervention trial. Osteoporos Int. 2016;27:899–903. doi: 10.1007/s00198-015-3478-2.
    1. Waterloo S, Nguyen T, Ahmed LA, Center JR, Morseth B, Nguyen ND, Eisman JA, Søgaard AJ, Emaus N. Important risk factors and attributable risk of vertebral fractures in the population-based Tromsø study. BMC Musculoskelet Disord. 2012;13:163. doi: 10.1186/1471-2474-13-3.
    1. Waterloo S, Søgaard AJ, Ahmed LA, Damsgård E, Morseth B, Emaus N. Vertebral fractures and self-perceived health in elderly women and men in a population-based cross-sectional study: The Tromsø Study 2007–08. BMC Geriatr. 2013;13:102. doi: 10.1186/1471-2318-13-102.
    1. Zhang JQ, Xu WY, Xu CQ. Neonatal propofol and etomidate exposure enhance inhibitory synaptic transmission in hippocampal cornus ammonis 1 pyramidal neurons. Chin Med J (Engl) 2016;129:2714–2724. doi: 10.4103/0366-6999.193459.
    1. Mu DL, Li LH, Wang DX, Li N, Shan GJ, Li J, Yu QJ, Shi CX. High postoperative serum cortisol level is associated with increased risk of cognitive dysfunction early after coronary artery bypass graft surgery: A prospective cohort study. PLoS One. 2013;8:e77637. doi: 10.1371/journal.pone.0077637.
    1. Wang R, Chen J, Wu G. Variable lung protective mechanical ventilation decreases incidence of postoperative delirium and cognitive dysfunction during open abdominal surgery. Int J Clin Exp Med. 2015;8:21208–21214.
    1. Papadopoulos G, Karanikolas M, Liarmakopoulou A, Papathanakos G, Korre M, Beris A. Cerebral oximetry and cognitive dysfunction in elderly patients undergoing surgery for hip fractures: A prospective observational study. Open Orthop J. 2012;6:400–405. doi: 10.2174/1874325001206010400.
    1. Sclar DA. Remifentanil, fentanyl, or the combination in surgical procedures in the United States: Predictors of use in patients with organ impairment or obesity. Clin Drug Investig. 2015;35:53–59. doi: 10.1007/s40261-014-0251-9.
    1. Kim YH, Kwon HJ, Kim DS. Matrix metalloproteinase 9 (MMP-9)-dependent processing of βig-h3 protein regulates cell migration, invasion, and adhesion. J Biol Chem. 2012;287:38957–38969. doi: 10.1074/jbc.M112.357863.
    1. Zhu PP, Yuan SG, Liao Y, Qin LL, Liao WJ. High level of intercellular adhesion molecule-1 affects prognosis of patients with hepatocellular carcinoma. World J Gastroenterol. 2015;21:7254–7263. doi: 10.3748/wjg.v21.i23.7254.
    1. Zhang X, Zhou Y, Xu M, Chen G. Autophagy is involved in the sevoflurane anesthesia-induced cognitive dysfunction of aged rats. PLoS One. 2016;11:e153505.
    1. Sato C, Sekiguchi A, Kawai M, Kotozaki Y, Nouchi R, Tada H, Takeuchi H, Ishida T, Taki Y, Kawashima R, Ohuchi N. Postoperative structural brain changes and cognitive dysfunction in patients with breast cancer. PLoS One. 2015;10:e140655. doi: 10.1371/journal.pone.0140655.

Source: PubMed

3
Iratkozz fel