Effects Of Lidocaine And Dexmedetomidine On Serum S100? Protein,NSE Content And Cerebral Oxygen Supply And Demand In Patients

Objective: lidocaine and dexmedetomidine has many ways in neuroprotective effect,this paper studies the effects of lidocaine and Dexmedetomidine alone or in combination on the patients with meningioma resection perioperation in cerebral oxygen balance and the concentration of S100? protein,NSE content in internal jugular vein bulb,to assess whether there is a synergistic effect of the two drugs.Methods: select 60 cases of the patients undergoing meningioma resection,which aged 55 to 65 years old?weighing 55 kg ~ 65 kg and in the grade II or III of the American Society of anesthesiologists(ASA).divide the 60 cases into 4 groups(15 cases in each group)with Randomly were.they are control group(group A),lidocaine group(group L),dexmedetomidine group(group D),lidocaine combined with dexmedetomidine group(group LD),L group injection 2% lidocaine 1.5 mg.kg-1 at the start of skin incision,then continuous infusion until the end of operation at the speed of 2mg.kg-1.h-1.In group D,1?g.kg-1 of dexmedetomidine was given at the beginning of the skin incision,and 15 min infusion was completed.Then,it was injected at a speed of 0.5?g.kg-1.h-1 to the end of the operation.In group LD lidocaine and dexmedetomidine used as so as in group L and group D.A group at the same point of the same amount of 0.9% saline.To maintain bispectral index among the 4 groups(bispectral index,BIS)in 40 ~ 50,respectively,before skin incision(T1),at the end of surgery(T2),24 h after operation(T3)synchronous acquisition of internal jugular vein and dorsal arterial blood at 3 time points,blood gas analysis,and record blood red protein(Hb),hematocrit(Hct),mean arterial pressure at the time of recording the same(MAP)and heart rate(HR).Determination of artery and jugular venous oxygen saturation(SaO2,SjvO2),the oxygen partial pressure(PaO2,PjvO2),calculate the blood oxygen content(CaO2,CjvO2)and the oxygen content difference(Ca-jvO2),cerebral oxygen uptake rate(CERO2);Determination the S100? protein(S100?)and NSE(Neuron-specific enolase)content of jugular bulb serum.Result:1.CaO2 in the four groups of T2,T3 time point were lower than that of time point T1(T1 > T2 > T3),the difference between the time point of T3 and the time point of T1,T2 were statistically significant(P <0.05);2.The Ca-jvO2 and CERO2 value in group of L,D,LD of time point T2,T3 were lower than that of T1 time point(T1> T3 > T2),the difference was statistically significant(P <0.05),but the Ca-jvO2 and CERO2 value in A group of T2,T3 time point are more than that at T1 time point(T1< T2 < T3),the difference between the time point of T3 and the time point of T1 were statistically significant(P <0.05);3.Compared with the group of A,The Ca-jvO2 and CERO2 value in the group of L,group of D,group of LD were decreased(group A > group L > group D > group LD),the difference was statistically significant(P <0.05);4.The S100? protein,NSE concentration in four groups was significantly increased at T2 time point(P <0.05),which in group of L,D and LD at time point of T3 was decreased than time point of T3,the difference was statistically significant(P <0.05),Which in the group of A at time point T3 was decreased than at the time point of T2,the difference was not statistically significant,group A,T2 > T3 > T1.group of L,group of D,group of LD,T2 > T1 > T3;5.Compared with the group of A,the S100? protein and NSE concentration in the group of L,D,LD at the time point of T2,T3 were decreased(group LD< group L< group D < group A),The difference were statistically significant(P <0.05).