Preventive Effect of Different Doses of Nimodipine Intraoperative Irrigation on Postoperative Cerebral Vasospasm in Patients Undergoing Craniotomy for Intracranial Aneurysms

SHENG Chengjun; JI Shiyu

doi:10.16458/j.cnki.1007-0893.2025.15.005

Abstract：Objective To explore the preventive effect of different doses of nimodipine intraoperative irrigation on postoperative cerebral vasospasm in patients undergoing craniotomy for intracranial aneurysms.Methods A total of 164 patients with intracranial aneurysms admitted to Nanyang Central Hospital from February 2022 to January 2025 were selected as the research subjects and randomly divided into a control group and an observation group,with 82 cases in each group.Both groups underwent craniotomy and clipping.The observation group received 5 mg nimodipine+100 mL 0.9%sodium chloride injection for intraoperative irrigation,while the control group received 2 mg nimodipine+100 mL 0.9%sodium chloride injection for intraoperative irrigation.The cerebral blood flow velocity,brain injury indicators,postoperative cerebral vasospasm occurrence,prognosis and adverse reactions were compared between the two groups.Results Three days after the operation,the peak systolic velocity of the middle cerebral artery,the peak systolic velocity of the posterior cerebral artery,the serum levels of S100β and NSE in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05);the total incidence of postoperative cerebral vasospasm in the observation group was lower than that in the control group,and the total good prognosis rate was higher than that in the control group,and the differences were statistically significant(P<0.05);there was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Compared with 2 mg nimodipine dose,5 mg nimodipine dose during craniotomy for intracranial aneurysms is more effective,which can effectively promote cerebral blood perfusion,reduce brain tissue injury,lower the incidence of cerebral vasospasm,improve prognosis,and does not increase adverse reactions.