The Minimum Alveolar Concentration Of Desflurane Is Varied In Patients With End-Stage Renal Disease

ObjectiveThe purpose of this study was to investigate the concentration variations of the minimum alveolar concentration(MAC)-awake of desflurane and the neuron specific enolase(NSE)in patients with end-stage renal disease and the correlation of each other.MethodsTwenty-two cases of end-stage renal disease patients and urolithiasis patients were chosen as Group I,Groupc.Patients underwent inhalational induction of anesthesia with desflurane.MAC_awakewas determined in each patient by observing the response to a verbal command(open eyes on request).An end-tidal anesthetic concentration was maintained at an initial target level of 1.4%for 15 min before a command.If a positive response was observed,the concentration of desflurane was increased by 0.1%and again kept constant for 15 min.The verbal command was then continued.This process was repeated until an end-tidal concentration was reached at which the patient did not respond to command.The anesthetic concentration midway between the value permitting the response and that just preventing the response was defined as MAC_awakefor each patient.Blood samples(5ml) of each group were gotten through venipuncture.After filtrated by double layered sterile pledget,the samples were centrifugated at 3000r/m for 15 minutes.The supernatant liquid were collected and the concentration of neuronspecific enolase(NSE)was detected by Double antibodies sandwich enzyme linked immunosorbent assay(ELISA).ResultsThe MAC_awakeof desflurane for patients with obstructive jaundice (1.26±0.62)%was significantly less than those observed for the control group (2.28±0.32)%;P < 0.001and the concentration of neuron specific enolase (NSE)in the blood was significantly more than those observed for the control group(22.4±16 vs 11.32±3.8;p<0.001).The MAC_awakeof desflurane correlated significantly with the concentration of NSE(r=-0.58,P=0.004).ConclusionThe pathophysiologycal injury in the central nervous system in patients with end-stage renal disease may lead to the altered sensitivity to inhaled anesthetics.