Cerebral Protection Of Hypertonic Sodium Chloride Hydroxyethyl Starch 40 Injection In Anesthesia Induction Period

Objective:To investigate the cerebral protection of pre-injecting hypertonic sodium chloride hydroxyethyl starch 40 injection on liver tumor patients with hypertension in combined general-epidural anesthesia induction period.Methods:Fifty undergoing tumor of liver with hypertension patients (ASAⅡ～Ⅲ) in our hospital during 2008.9 to 2009.7 were chosen. They were all make a definite diagnosis through CT and ensured after operation with Routine pathological mechan-ism. All patients have no other serious system diseases.They were randomly divided into 2 groups:group H(hypertonic sodium chloride hydroxyethyl starch 40 injection), group R (Sodium chloride compound)(n=25).All patients were deployed with combin-ed general-epidural anesthesia. Epidural (T8-9), radial arteries and right jugular veins were catheterized under local anesthesia in all patients. Then group H or group R was injected at a speed of 4ml/kg within 30min for patients. Anesthesia was administered for all patients at 20min after solution infusion. Mean arterial pressure (MAP), central venous pressure (CVP) and heart rate (HR) were recorded before solution infusion (T 0), immediate after infusion (T1), immediate after tracheal intubation (T2),5 min (T3) after tracheal intubation,15 min after tracheal intubation (T4),30 min after tracheal intubation(T5). Draw vein blood and saved serum after centrifugal separation at same time-points respectively. Serum S100B,IL-6 and TNF-a were measured.Results:Compared with T0, group H, S100B reduced slightly (P>0.05), IL-6,TNF-a have no marked change. Group R, S100B increased obviously at T5 (P＜0.01), IL-6 and TNF-a increased obviously(P<0.05 or P<0.01). Compared with group R, group H HR reduced obviously, MAP and CVP elevated obviously from T2 to T5(P<0.05 or P<0.01);S100B IL-6 and TNF-a reduced obviously from T3 to T5(P<0.05orP<0.01).Conclusion:The findings of the present study demonstrated that hypertonic sodium chloride hydroxyethyl starch 40 injection (4ml/kg) can lower the S100B levels by maintaining the good cerebral perfusion pressure, reducing intracranial pressure, reducing the inflammatory response during the combined general-epidural anesthesia induction period. Hypertonic sodium chloride hydroxyethyl starch 40 injection may have cerebral protection on liver tumor patients with hypertension in combined general-epidural anesthesia induction period.