Protective Effect Of Sevoflurane On Cerebral Ischemia-reperfusion Injury

Objective:To explore the effect of sevoflurane on cerebral ischemia-reperfusion injury before and after parent artery occlusion during clipping of intracranial aneurysm,as well as its potential mechanism.Methods:60 patients undergoing clipping of intracranial aneurysm in our hospital from March 2017 to June 2018 were selected and randomly divided into sevoflurane group?group S?and control group?group C?,n=30.Group C adopted venous anesthesia alone,while group S had inhaled 2%sevoflurane for 30 min before parent artery occlusion and after patency of parent artery,respectively,based on venous anesthesia.Other treatments were the same as the control group.The mean arterial pressure?MAP?and heart rate?HR?in both groups before parent artery occlusion?T₁?,5 min after parent artery occlusion?T₃?,and 5 min after patency of parent artery?T₅?were recorded.Moreover,the jugular venous blood was collected from patients in both groups before anesthesia induction?T₀?,at the time of parent artery occlusion?T₂?,at the time of patency of parent artery?T₄?,2 h after patency?T₆?,6 h after patency?T₇?,and 24 h after patency?T₈?.ELISA was used to detect the concentration of S100?protein and TNF-?in serum and thiobarbituric acid method was used to detect the concentration of MDA in serum.In addition,the dosage of propofol,sufentanil and remifentanil were compared.Results:1.Differences in MAP and HR between two groups were not statistically significant?P>0.05?.2.After parent artery occlusion,the level of S100?protein,TNF-?and MDA were significantly increased comparing with T₀ in two groups?P<0.05?,which had the statistical significance.However,the level of S100?protein,TNF-?and MDA reached the peak at T₇,descended at T₈,the level at T₈ was still higher than T₀?P<0.05?.Compared with group C,S100?protein,TNF-?and MDA in group S at T₄,T₆,T₇,T₈ was significantly lower?P<0.05?,which had the statistical significance.3.The dosage of propofol in group S were lower than group C obviously?P<0.05?,but the dosage of sufentanil and remifentanil in two groups has no significant difference.Conclusions:Sevoflurane shows certain protection on cerebral ischemia-reperfusion injury,and its mechanism may be related to the suppression of excessive inflammatory response and oxidative stress response.Sevoflurane is safer and more effective for patients with the risk of ischemia-reperfusion during operation.