Comparison of two different anesthesia regimens in spinal neurosurgery

Abstract

Objective To investigate the effects of sevoflurane with remifentanil (group SR) and propofol with remifentanil (group PR) on blood glucose, C⁃reactive protein (CRP) and achievement ratio of motor evoked potential (MEP) monitoring in patients undergoing spinal neurosurgery. Methods All patients in 2 groups were induced with midazolam, propofol, sufentanil and rocuronium bromide. Anesthesia was maintained with sevoflurane in group SR while propofol in group PR. Depth of anesthesia adaptation was according to bispectral index (BIS). Blood glucose and hemodynamics were observed at different time points. Achievement ratio of MEP monitoring was compared. Results There were no apparent fluctuations of hemodynamics in both groups. Mean arterial pressure (MAP) was higher after induction in group PR than that in group SR (P < 0.05). Heart rate (HR) in both groups were lower at 60 and 120 min after induction than baseline (P < 0.05, for all). HR was lower at 5 min after induction in group PR than that in group SR (P < 0.05). No significant difference was shown in blood glucose between 2 groups (P > 0.05). CRP level in both groups was significantly higher at 24 h after operation than that before induction (P < 0.05, for all), and it was more higher in group SR than that in group PR (P < 0.05). Achievement ratio of MEP monitoring in group PR was higher than that in group SR (P < 0.05). Conclusion Two anesthetic regimens are compatible during spinal neurosurgery, with no apparent fluctuations of perioperative blood glucose. Inflammatory response is inhibited during operation but that at postoperation. Total intravenous anesthesia with propofol is more compatible for motor evoked potential monitoring.

DOI：10.3969/j.issn.1672-6731.2010.04.012