Sevoflurane Influences On The NSE And S100β Protein In The Serum Of The Patients Undergoing Craniocerebral Operations

Objective: Brain injury often lead to secondary cerebral ischemia and oxygen deficiency, aggravating brain damage. Therefore,how to carry out brain protection during craniocerebral operations is a key topic to many scholars. Sevoflurane is a new type of inhalational anesthesia drug which has been found that it has an effect on brain protection in animal experiments. By reviewing dynamic changes of the concentration of NSE and S100βprotein in patients who undergo meningioma resection to confirm that sevoflurane has a brain protection effect during craniocerebral operations and its superiority.Method: 24 patients(ASA I~II, 40~65 years old) are scheduled for craniocerebral operations. The patients are randomly divided into sevoflurane 2%(S1 group), sevoflurane 4%(S2 group) and propofol group(P group). each of them has 8 cases. Preoperative tests and chemical examination are normal. After entering operating room,monitoring of ECG,SpO2 and BP are carried out on the patients,Midazolam 0.05mg·kg-1, sulfentanyl 0.5ug·kg-1, cis-Atracurium 0.15 mg·kg-1 and etomidate 0.3 mg·kg-1 are adopted in anesthesia induction. Tracheal intubation is followed by mechanical ventilation. Prime setting:breathing rate(f)12times·min-1, VT 10 mL·kg-1,fresh gas flow 1.5 L·min-1. Adjusting f and VT according to SpO2 and partial pressure of carbon dioxide in end expiratory gas(PETCO2), to maintain SpO2 98%～100%,PETCO2 27～30 mmHg. All patients are divided into three groups(S1 group, S2 group, P group). Maintenance of anesthesia in S1 group is done by breathing in 2% Sevoflurane, Maintenance of anesthesia in S2group is done by breathing in 4% Sevoflurane, Maintenance of anesthesia in B group is done by pumping propofol(5mg/kg/h) via vein. Venous blood is collected at five time points:T1(24h before operation), T2 (after anesthesia induction), T3(2h after operation), T4(4h after operation), T5(24h after operation). The changes of NSE and S100βprotein concentration were adopted by ELISA method. Scoring MMSE 24h before operation and 24h after operation. Statistical treatment is completed with SPSS13.0 package. Measurement data is expressed by mean(X)±standard deviation(s), T test is used in comparison between groups. ANOVA is used in comparison within the group, P<0.05 is considered as statistical significant difference.Result: Comparison of MMSE scores shows that postoperative 24h scores are lower than preoperative 24h scores (P<0.05); postoperative 24h scores in S1, S2 group are higher than in B group(P<0.05). Concentration measurement shows that concentration of S100βprotein in sevoflurane group is obviously lower than that in propofol group, especially 2h and 24h after operation. NSE concentration measurement of the patients serum shows that concentration of NSE in sevoflurane group is remarkably lower than that in propofol group, especially 2h , 4h and 24h after operation.Conclusion:Comparation with propofol, sevoflurane has a preferable effect on brain protection in craniocerebral operation. And sevoflurane 4% is better than 2% in brain protection.