Background To investigate whether intravenous propofol before endotracheal suctioning (ES) in severe neuropathy patients can reduce the sputum suction response, improve the prognosis, and accelerate recovery.
Methods A total of 208 severe neuropathy patients after craniocerebral surgery were enrolled in the study. The subjects were randomly divided into the experimental group (n=104) and the control group (n=104). The experimental group was given intravenous propofol, 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, and length of stay and hospitalization cost were evaluated. Additionally, the Glasgow Outcome Scale (GOS) prognosis score was obtained at six months after the operation.
Results At 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 and pain 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). The difference 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.
Conclusions Propofol sedation before ES can reduce the choking cough response, the pain experience of patients, and the intracranial hypertension response. The use of propofol is safe and improves long-term prognosis.
The study was registered on May 16, 2015 at Chinese Clinical Trail Registry (ChiCTR-IOR-15006441).