Effects Of Isoflurane On The Concentration Of TNF-a And IL-8 Induced By Mechanical Ventilation During One Lung Ventilation In The Bronchoalveolar Lavage

Objective: The purpose of this study was to investigate effects of isoflurane on the concentration of TNF-a and IL-8 in the bronchoalveolar lavage,which induced by mechanical ventilation during one-lung ventilation.Methods: Forty patients undergoing thoracic surgery. Exclusion criteria were as follows: Patients with cardiac(>New York Heart Association II) or pulmonary diseases(VC or FEV₁<50% of the predicted values), pulmonary hypertension (mean pulmonary artery pressure[MPAP] >30 mmHg) and pre-existing coagulation disorders or treated with immune modulators (cytostatic drugs, corticosteroids and nonsteroidal anti-inflammatory drugs, vaccination, blood products) within 3 month before surgery were not enrolled into the study; Patients with current nicotine abuse and with symptoms of an acute inflammatory process (clinically defined or abnormal data for C-reactive protein, leukocyte count, or body temperature) were also excluded. No significant difference existed between two groups in ASA grade,age,body height, The patients were randomized to receive either 1.2Vol % isoflurane (group I, n=20) anesthesia or without isoflurane (group C) . BAL fluids samples were achieved before (to), 20min after OLV (t₁) and 90min after OLV (t₂). Pro-inflammatory (TNF-a, IL-8) in BAL fluids were determined. Statistics treatment:The measurement data was expressed as "x|-±s", and using Paired- T Test program and One-Way ANOVA program of SPSS 13.0 software to analyze it.when the value of "p" is lower than 0.05,it has significance.Results: The age,body height,body weight and operation time,OLV time had no significant difference between two groups (P >0.05) . The concentrations of BAL IL-8 and TNF-a at T₀ had no significant difference between two groups (P >0.05) . The concentrations of IL—8 and TNF—a at T₁ and T₂ increased significantly compared to baseline(T₀) in both groups(P < 0.05).The concentrations of IL—8 at T₁ and T₂ were significantly lower in isoflurane group than that in control group (P<0.05), and TNF—a were significantly lower in isoflurane group than that in control group (P<0.05) at T₂.Conclusion: In both groups, IL-8 and TNF-a concentrations were significantly higher after OLV , and lower after inhalation with isoflurane in contrast to control group.