Application effect of propofol combined with etomidate on anesthesia maintenance during thoracoscopic surgery on tuberculous empyema patients
Lei Nana
Ma Li
Xu Fenlan
You Jia
Abstract：Objective To explore the application effect of propofol combined with etomidate on anesthesia maintenance during thoracoscopic surgery on patients with tuberculous empyema.Methods A total of 216 patients with tuberculous empyema who underwent thoracoscopic surgery in Public Health Clinical Center of Chengdu from January 2022 to April 2024 were selected and randomly divided into the observation group and the control group,with 108 cases in each group.The control group received propo-fol for anesthesia maintenance and the observation group received propofol combined with etomidate for anesthesia maintenance.The heart rate,mean arterial pressure,and superoxide dismutase and malondialdehyde levels were observed and compared between the two groups of patients before the anesthesia(T0),at the start of surgery(T1),30 minutes of surgery(T2),and 3 minutes after ex-tubation(T3).The Visual Analog Scale(VAS)scores for pain were compared between the two groups at 6,12,24,and 48 hours after the surgery;the Mini-Mental State Examination(MMSE)scores were compared between the two groups at 24 hours before the sur-gery,and 24 and 48 hours after the surgery;the incidence rates of postoperative adverse reactions were compared between the two groups.Results There were significant differences in heart rates and mean arterial pressure between the two groups at different time points(F time=180.561,319.566,P<0.05).There were significant differences between the two groups(F group=63.036,56.778,P<0.05).There was an interaction between groups and time points(F interaction=7.852,6.256,P<0.05).The heart rate and mean arterial pressure of the observation group were respectively(71.42±4.15)beats·min-1,(73.17±4.53)beats·min-1,(77.64±5.11)beats·min-1,(81.56±7.25)mmHg,(77.15±6.82)mmHg and(94.37±8.84)mmHg at T1～T3,all higher than(67.61±3.24)beats·min-1,(69.52±3.63)beats·min-1,(74.26±4.75)beats·min-1,(76.68±6.56)mmHg,(72.13±6.21)mmHg and(87.53±8.12)mmHg of the control group(t heart rate=7.520,6.534,5.035,t mean arterial pressure=5.187,5.656,5.922,P<0.05).There were significant differences in superoxide dis-mutase and malondialdehyde between the two groups at different time points(F time=289.123,159.513,P<0.05).There were signifi-cant differences between the two groups(F group=91.971,65.706,P<0.05).There was an interaction between groups and time points(F interaction=8.615,9.429,P<0.05).The levels of superoxide dismutase and malondialdehyde of the observation group were respectively(70.31±5.56)U·L-1,(66.38±5.13)U·L-1,(61.34±6.61)U·L-1,(6.22±1.25)mmol·L-1,(7.25±1.27)mmol·L-1 and(7.37±1.34)mmol·L-1 at T1～T3,better than(65.76±6.22)U·L-1,(60.82±5.34)U·L-1,(56.89±5.32)U·L-1,(7.19±1.26)mmol·L-1,(8.17±1.32)mmol·L-1 and(8.65±2.11)mmol·L-1 of the control group(t=5.668,7.803,5.450,t=5.680,5.220,5.322,P<0.05).There were significant differences in the VAS scores between the two groups at different time points(Ftime=259.235,P<0.05),with statistically significant differences between the two groups(Fgroup=165.112,P<0.05),and an interaction between groups and time points(Finteraction=4.473,P<0.05).The VAS scores of the observation group were respectively(4.38±1.12)point,(5.47±1.08)point,(3.66±1.11)point and(2.75±1.22)point at 6,12,24 and 48 hours after the surgery,lower than(5.69±1.09)point,(6.62±1.05)point,(4.85±1.17)point and(3.27±1.26)point of the control group(t=8.711,7.934,7.688,3.081,P<0.05).There were significant differences in the MMSE scores between the two groups at different time points(F time=215.853,P<0.05),while there were no significant differences between the two groups(F group=1.926,P=0.167).There was an interaction between groups and time points(F interaction=3.324,P<0.05)and at 24 hours after the surgery,the MMSE score of the observation group was higher than that of the control group(P<0.05).The total incidence of adverse reactions was 7.41%(8/108)in the observation group,lower than 16.67%(18/108)in the control group(χ2=4.372,P<0.05).Conclusion Propofol combined with etomidate demonstrates excellent efficacy during the anesthesia maintenance phase of thora-coscopic surgery in patients with tuberculous empyema.It effectively maintains intraoperative hemodynamic stability,reduces oxida-tive stress responses,alleviates postoperative pain,and exhibits favorable safety.
Keywords：Tuberculous empyemaThoracoscopic surgeryPropofolEtomidateAnesthesia maintenance
Publication Date：2025-06-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 397-401 )