Effect of propofol on cerebral blood flow in patients with severe traumatic brain injury undergoing decompression craniectomy

Abstract

Objective To analyze the effect of propofol on cerebral blood flow (CBF) in patients with severe traumatic brain injury (sTBI). Methods A total of 60 patients of sTBI undergoing unilateral decompression craniectomy in the Department of Neurosurgery from January 2015 to April 2018 were reviewed. Patients were divided into control group (no propofol, but other types of sedatives were used) or propofol group (propofol was used without other types ofsedatives), according to whether they were treated with propofol after surgery. Each group contained 30 cases. Before and 2 h after the use of sedative drugs, the mean blood flow velocity (V mean) and resistivity index (RI) of the affected middle cerebral artery (MCA) were detected by ultrasound through the temporal skull defect, and adverse effects of propofol were recorded. Glasgow Outcome Scale (GOS) was used to evaluate long ⁃ term outcome, and mortality was also compared, after a 6 months follow⁃up. Results The Vmean of the affected MCA was decreased after using sedative in both the 2 groups of patients compared with before using it (P = 0.000), and there was no significant difference of RI observed in the affected MCA before and after sedative administration (P = 0.129). Compared with the control group, V mean (P = 0.000) and RI ( P = 0.033) in the MCA of propofol group were decreased after sedative administration. The outcomes of the propofol group and control group were (2.37 ± 0.81) score vs. (2.67 ± 0.76) score ( t = 1.482, P = 0.144) and the mortalities were 4 cases (13.33%) v s. 2 cases (6.67%; adju sted χ2 = 0.185, P = 0.667). Conclusions Propofol can improve CBF in patients with sTBI by reducing V meanand RI of the affected MCA, but it has no obvious effect on mortality and long ⁃ term outcome.DOI：10.3969/j.issn.1672⁃6731.2020.04.016