Effects of propofol on intracranial pressure and prognosis in patients with severe brain diseases undergoing endotracheal suctioning

BMC Neurology

Xiaorong Yin¹  Ling Ye¹  Maojun Chen²  Maojie Zhang²  Yujuan Long²  Menghang Wu²  Lihui Pu²  Zhi Hu²  Xia Zhang²  Xiaomei Wu²  Yan Liu²  Tingting Li² 

[1] Department of Pain Management, West China Hospital, Sichuan University, 610041, Chengdu, Sichuan Province, P. R. China;West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, 610041, Chengdu, Sichuan Province, P. R. China;

关键词: Severe neuropathy;    Severe brain disease;    Endotracheal suctioning (ES);    Propofol;    Sedation;    Intracranial pressure (ICP);    Nursing;   

DOI  :  10.1186/s12883-020-01972-1

来源: Springer

【 摘 要 】

BackgroundTo investigate whether the administration of intravenous propofol before endotracheal suctioning (ES) in patients with severe brain disease can reduce the sputum suction response, improve prognosis, and accelerate recovery.MethodsA total of 208 severe brain disease patients after craniocerebral surgery were enrolled in the study. The subjects were randomly assigned to the experimental group (n = 104) and the control group (n = 104). The experimental group was given intravenous propofol (10 ml propofol with 1 ml 2% lidocaine), 0.5–1 mg/kg, before ES, while the control group was subjected to ES only. Changes in vital signs, sputum suction effect, the fluctuation range of intracranial pressure (ICP) before and after ES, choking cough response, short-term complications, length of stay, and hospitalization cost were evaluated. Additionally, the Glasgow Outcome Scale (GOS) prognosis score was obtained at 6 months after the operation.ResultsAt the baseline, the characteristics of the two groups were comparable (P > 0.05). The increase of systolic blood pressure after ES was higher in the control group than in the experimental group (P < 0.05). The average peak value of ICP in the experimental group during the suctioning (15.57 ± 12.31 mmHg) was lower than in the control group (18.24 ± 8.99 mmHg; P < 0.05). The percentage of patients experiencing cough reaction- during suctioning in the experimental group was lower than in the control group (P < 0.05), and the fluctuation range of ICP was increased (P < 0.0001). The effect of ES was achieved in both groups. The incidence of short-term complications in the two groups was comparable (P > 0.05). At 6 months after the surgery, the GOS scores were significantly higher in the experimental than in the control group (4–5 points, 51.54% vs. 32.64%; 1–3 points, 48.46% vs. 67.36%; P < 0.05). There was no significant difference in the length of stay and hospitalization cost between the two groups.ConclusionsPropofol sedation before ES could reduce choking cough response and intracranial hypertension response. The use of propofol was safe and improved the long-term prognosis.The study was registered in the Chinese Clinical Trial Registry on May 16, 2015 (ChiCTR-IOR-15006441).

【 授权许可】

CC BY