Effects Of Sevoflurane Preconditioning On Pulmonary Function In Patients Undergoing Pulmonary Lobectomy During One Lung Ventilation

Objective:To investigate the Effects of sevoflurane preconditioning on pulmonary function in patients undergoing pulmonary lobectomy during one lung ventilation(OLV).Methods:In strict accordance with the screening criteria,select forty patients undergoing pulmonary lobectomy.And randomly divided into two groups:sevoflurane preconditioning group(group S,n=20)and control group(group P,n=20).After general anesthesia induction and intubation,patients in group S received sevoflurane at 1.0 minimum alveolar concentration(MAC)for 30 min as a preconditioning and then replaced by oxygen for a compete rapid gas exchange to reduce the sevoflurane inhalation concentration to zero before OLV.While in group P,only intravenous anesthetic agents were administrated for maintaining of anesthesia after induction.Blood samples were taken at the following time points:before anesthesia(T0),after anesthesia induction at lateral position two lung ventilation(TLV)15 min(T1),30 min after OLV(T2),60 min after OLV(T3),recovering TLV 30 min(T4),6 h after operation(T5)and 2 d after operation(T6).Plasma Kreb Von den Lungen-6(KL-6)was measured by means of sandwich Enzyme-linkded immunosorbent assay(ELISA).Measured Dynamic pulmonary compliance(Cdyn)at T1,T2,T3,T4.Results:Two groups of patients’ gender,age,BMI,FEV,/FVC,OLV time and operation time differences had no statistical significance(p>0.05).Two groups of patients’ Cdyn differences at T,had no statistical significance(p>0.05).Compared with T1,the Cdyn decreased significantly at T2,T3,and dropped to the lowest point at T3(p<0.05).Compared with group P,the Cdyn was obviously higher than that in group S at T2,T3(p<0.05).Two groups of the plasma KL-6 concentration differences at T0,T1 had no statistical significance(p>0.05).Compared with T1,the plasma KL-6 concentration increased significantly at T2,T3,T4,T5(p<0.05).Compared with TS,in both groups the plasma KL-6 concentration decreased significantly at T6(p<0.05).Compared with group P,the plasma KL-6 concentration was obviously lower than that in group S at T2,T3,T4,T5,T6(p<0.05).Conclusion:Sevoflurane preconditioning may obviously decrease the elevatory level of the plasma KL-6 concentration and significantly decrease the decreased level of the Cdyn.Sevoflurane preconditioning has certain protective effect on OLV induced lung injury.