| Objective:To study the brain protective effectiveness of the perioperative application of flurbiprofen axetil by mental scale and S100β,NSE serum, and the safety by physiological indexes, to explore the brain protective mechanism by the cerebral oxidoreduction and inflammation.Methods:30 cases with aneurysm clip craniotomy, glioma, meningioma from March 2013 to April 2014 in Bethune international peace hospital undergoing elective general anesthesia, aged 40～60 years, ASA I-II, agreed by the hospital ethics committee, and signed the informed consent to relatives. F (flurbiprofen axetil group) intraoperative pump injection flurbiprofen axetil 0.25 mg.kg-1.h-1, group C (control group) will not be pumping flurbiprofen axetil. All the cases intravenous input first 10 ml.kg-1 of ringer’s lactate solution, RR. Local anesthesia central venous puncture retrograde catheter. Anesthesia induction by fentany 4μg.kg-1, propofol 2mg.kg-1,rocuronium 1 mg.kg-1. then mechanical ventilation after Endotracheal intubation, respiratory frequency 12 times per minute, tidal volume 8.kg-1, I:E= 1:2, oxygen 2.5L.min-1, vein pump injection of propofol 0.6mg.kg-h-1, remifentani10.18μg.kg-1.min-1, cis atracurium 0.2mg.kg-1h-1.GCS, MMSE score were observed in 12 h Preoperative and 12 h,24 h postoperative; MAP, HR, TV, breathing rate and SPO2 were Measured; NSE å'Œ100βwere measured by chemiluminescence immune clamp method and the serum SOD, MDA and the serum TNF alpha, IL-6. of internal jugular vein ball were measured.before induction of general anesthesia (T1), cut the dura immediately (T2), the end of operation (T3),6h after operation (T4) 24 h after operation (T5).Results:1 the comparison of general data:The age, weight, diseases, gender, weight and duration are no statistical difference in twogroups (P> 0.05).2 the comparison in effectiveness (neurologic monitoring)2.1 mental scale2.1.1 GCS scoreComparison in group:compared with 12 hpreoperative,, there was no statistical difference in 12 h,24 h after surgery in two groups (P> 0.05). Comparison between groups:GCS score was no statistical difference between two groups with in three points, (P> 0.05).2.1.2 MMSE scoreComparison in group:compared with preoperative 12 h, two groups of postoperative 12 h,24 h after surgery were lower with statistical significance (P<0.05).Comparison between groups:MMSE score no statistical difference between two groups in preoperative 12 h, (P> 0.05). Compared with group C, F group of patients after 12 h,24 h after surgery are high, with statistical significance (P< 0.05).2.2 NSE and S100βComparison in group:Compared with T1, NSE and S 100β of two groups are increased, with statistical significance in T2-T5 (P< 0.05).compared between groups:Compared with group C, NSE and S100βwere lower in group F in T2～T5 point with statistical significance (P< 0.05).3. the comparison in safety (physiological monitoring)3.1 HemodynamicsComparison in group:Compared with T1, there were no statistical significance in MAP, HR of two groups at T2-T5 point (P> 0.05).comparison between groups:there were no statistical significance in MAP, HR between two groups (P> 0.05).3.2 RespirationComparison in group:Compared with T1, there were no statistical significance in TV, breathing rate, blood oxygen saturation at T4 and T5 point (P>0.05).Comparison between groups:there were no statistical significance in TV, breathing rate, blood oxygen saturation between two groups at T1, T4, T5 (P> 0.05).4 The protection mechanism4.1 REDOX indicator(MDA and SOD)Comparison in group:Compared with T1, MDA were increased in both groups at T2-T5 point with statistical significance (P< 0.05); SOD were raised in group F (P< 0.05), while has no statistical significance in group C at T2～T5(P>0.05).comparison between groups:Compared with group C, MDA in group F concentrations were lower (P<0.05) and SOD in concentration F group were higher (P<0.05) at T2-T5 point.4.2 Inflammation factors (TNF alpha and IL-6)Comparison in group:Compared with T1, of TNF alpha and IL-6 concentrations are higher at T2-T5 in two groups (P<0.05). compared between group:Compared with group C, TNF alpha and IL-6 levels are lower at T2-T5 point in group F (P<0.05).Conclusion:11 It is safety of flurbiprofen Axetil application in patients with surgical operation;2 It is effection in brain protection of flurbiprofen Axetil application in patients with surgical operation;3 It is possible mechanisms including againsting ischemia-reperfusion injury effects and anti-inflammatory effects in brain protection of flurbiprofen Axetil application in patients with surgical operation... |
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