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已发表论文
瑞芬太尼-丙泊酚与单纯丙泊酚在重度创伤性脑损伤患者中的麻醉效果：一项回顾性队列研究
Authors Zhu J, Wei H, Jiang M, Li T, Wu R, Chen H
Received 12 June 2025
Accepted for publication 12 November 2025
Published 27 November 2025 Volume 2025:19 Pages 10561—10569
DOI https://doi.org/10.2147/DDDT.S546712
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Anastasios Lymperopoulos
Jianbin Zhu, Haixiang Wei, Minying Jiang, Ting Li, Ruizhu Wu, Hualiang Chen
Department of Anesthesiology, The First Hospital of Nanping City, Nanping, Fujian, 353000, People’s Republic of China
Correspondence: Hualiang Chen, Email tc0sop@163.com
Objective: To compare the effects of remifentanil-propofol versus propofol alone on anesthesia outcomes in patients undergoing surgery for severe traumatic brain injury (TBI).
Methods: In this single-center, retrospective cohort study, we analyzed the data of 113 consecutive severe TBI (GCS < 9) patients who underwent emergency neurosurgery. Patients were allocated into two groups based on the anesthesia maintenance regimen: the control group (n=56) received a continuous infusion of propofol alone, while the observation group (n=57) received a combination of remifentanil and propofol. The groups were well-matched at baseline. We compared anesthesia recovery times, hemodynamic parameters (SpO2, MAP, HR) at various time points, postoperative pain (VAS) and agitation (RSAS) scores, levels of inflammatory (TNF-α, IL-6) and neurological damage (S-100β, NSE) biomarkers, and 3-month neurological outcomes using the Glasgow Outcome Scale (GOS).
Results: Compared to the control group, the observation group demonstrated significantly shorter extubation time (13.54 ± 3.23 vs 24.79 ± 5.71 min, P < 0.001) and awakening time (8.72 ± 2.43 vs 17.21 ± 3.96 min, P < 0.001). The remifentanil-propofol regimen was associated with superior intraoperative hemodynamic stability for MAP and HR (Group and Interaction effects, P < 0.05). At 24 hours postoperatively, the observation group also exhibited lower VAS and RSAS scores (both P < 0.05), as well as reduced elevations in TNF-α, IL-6, S-100β, and NSE levels (all P < 0.05). Critically, a significantly higher proportion of patients in the observation group achieved a “Good Recovery” on the GOS at 3 months (54.39% vs 25.00%, P = 0.001).
Conclusion: For severe TBI surgery, remifentanil-propofol is associated with faster emergence, better hemodynamic control, reduced pain/agitation, attenuated neuro-inflammation, and improved long-term recovery versus propofol alone, suggesting significant clinical benefits. Prospective studies are warranted for confirmation.
Keywords: remifentanil, propofol, traumatic brain injury, anesthesia, clinical effects
Department of Anesthesiology, The First Hospital of Nanping City, Nanping, Fujian, 353000, People’s Republic of China
Correspondence: Hualiang Chen, Email tc0sop@163.com
Objective: To compare the effects of remifentanil-propofol versus propofol alone on anesthesia outcomes in patients undergoing surgery for severe traumatic brain injury (TBI).
Methods: In this single-center, retrospective cohort study, we analyzed the data of 113 consecutive severe TBI (GCS < 9) patients who underwent emergency neurosurgery. Patients were allocated into two groups based on the anesthesia maintenance regimen: the control group (n=56) received a continuous infusion of propofol alone, while the observation group (n=57) received a combination of remifentanil and propofol. The groups were well-matched at baseline. We compared anesthesia recovery times, hemodynamic parameters (SpO2, MAP, HR) at various time points, postoperative pain (VAS) and agitation (RSAS) scores, levels of inflammatory (TNF-α, IL-6) and neurological damage (S-100β, NSE) biomarkers, and 3-month neurological outcomes using the Glasgow Outcome Scale (GOS).
Results: Compared to the control group, the observation group demonstrated significantly shorter extubation time (13.54 ± 3.23 vs 24.79 ± 5.71 min, P < 0.001) and awakening time (8.72 ± 2.43 vs 17.21 ± 3.96 min, P < 0.001). The remifentanil-propofol regimen was associated with superior intraoperative hemodynamic stability for MAP and HR (Group and Interaction effects, P < 0.05). At 24 hours postoperatively, the observation group also exhibited lower VAS and RSAS scores (both P < 0.05), as well as reduced elevations in TNF-α, IL-6, S-100β, and NSE levels (all P < 0.05). Critically, a significantly higher proportion of patients in the observation group achieved a “Good Recovery” on the GOS at 3 months (54.39% vs 25.00%, P = 0.001).
Conclusion: For severe TBI surgery, remifentanil-propofol is associated with faster emergence, better hemodynamic control, reduced pain/agitation, attenuated neuro-inflammation, and improved long-term recovery versus propofol alone, suggesting significant clinical benefits. Prospective studies are warranted for confirmation.
Keywords: remifentanil, propofol, traumatic brain injury, anesthesia, clinical effects