The Effect Of Sevoflurane Preconditioning On NSE And S100β In Beating Heart Valve Replacement

Objective:to observe the changes of levels of NSE and S100β protein in patients suffer rheumatic heart disease by sevoflurane preconditioning during beating heart valve replacement.Methods:thirty patients undergoing beating heart valve replacement,aged between 18 and 65 yeas old, ASA Ⅲ or Ⅳ grade, were randomly divided into three groups:l% sevoflurane group(group SI),2% sevoflurane group(group S2),control group(group C). After anesthesia induction with midazolam+ cisatracurium besilate+ fentanyl+ etomidate, patients were suffered endotracheal intubationa and mechanical control of ventilation. Then group S1 received 1% sevoflurane, and group S2 received 2% sevoflurane for 30 min. After that, cardiopulmonary bypass was established. During surgery, patients’ mean aterial pressure was between 60 and 90 mmHg, anesthesia was maintained with midazolam+ cisatracurium besilate+ fentanyl. Blood sample was taken from radial artery for five observation time:before sevoflurane inhalation(T0)、 15 min after CPB (T1)、the end of CPB(T2)、the end of surgery(T3)、24h after surgery(T4).We detect the concentration of NSE and S100β protein from these blood samples.Results:NSE and S100βprotein concentration were elevated, and reach the peak at T2 for all groups. At different observation time, NSE and S100β protein density level was statistically significant difference (P<0.05). Compare with group C, NSE and S100βprotein density level in group S1 was not statistically significant difference at Ti-T4(P>0.05).Compare with group S1 and group C, NSE and S100β protein low density level in group S2 was statistically significant difference at Ti-T4(P<0.05).Conclusion:CPB can lead to rise concentration of NSE and S100β protein. sevoflurane may reduce concentration of NSE and S100β protein in patients suffer CPB, and protect brain.