Effects Of Remifentanil And Propofol TCI Anesthesia On Cerebral Oxygen Metabolism In Surgery Of Cerebral Tumor Patients

objective: To compare the effects of remifentanil and propofol TCI anesthesia on cerebral oxygen metabolism in surgery of brain tumor patients with isoflurane balanced anesthesia.Methods: 36 ASAâ… -â…¡elective intracranial tumor patients are allocated into isoflurane balanced anesthesia group(C group) (n=15) and TCI group(R group) (n=21) randomly. Patients in R group are inducted by propofol TCI with plasma concentration 3μg /ml and remifentanil TCI with plasma concentration 6 ng /ml, maintained with remifentanil and propofol TCI anesthesia. The plasma concentrations are adjusted according to stimulus and patients' response in surgery procedure. Patients in C group are inducted by propofol 2 mg/kg, fentanyl 0.2μg/kg and vecuronium 0.1 mg/kg^-1. After intubation 1%-2% isoflurane and vecuronium are administered according to stimulus and patients' response in surgery procedure. Monitoring and recording patients' BP,HR,SpO2 and P_ETCO₂ at time of preinduction( T₁), intubation( T₂), 5 min after intubation ( T₃), slicing the duramater( T₄), 30 min after removing tumor ( T₅), finishing operation ( T₆)and extubation( T₇) and recover time. SjvO2 and Da-jvO2 is tested at time of preinduction (t₁) , 30 min after induction(t₂), 1 h after induction (t₃), 2 h after induction(t₄), extubation(t₅).Results: Patients' BP, HR, SpO2 and PetCO2 are similar between two groups (P>0.05) . In both groups , patients' BP decrease significantly after induction (P<0.05) . Patients in C group recover more slowly than those in R group(P<0.05). SjvO₂ of C group is higher than that of R group while Ca-jvDO₂ of C group is lower than that of R group at time of t2,t3,t4 (p<0.05) . SjvO₂ at t2,t3,t4 is higher than that at t₁ while Da-jvO2 at t2,t3,t4 is lower than that at t₁ in C group (P<0.05) .Conclusions: Both remifentanil and propofol TCI anesthesia and isoflurane balanced anesthesia can maitain smooth life signs in surgery of cerebral tumor patients. Patients anesthetized with remifentanil and propofol TCI recovered more fast than those anesthetized with isoflurane balanced anesthesia. Remifentanil and propofol TCI anesthesia can balance oxygen supply consumption better than isoflurane balanced anesthesia during operation.