The Change Of Endothelin And Calcitonin Gene-related Peptide During The Embolization Of Intracranial Aneurysmsa And Its Influence From Nimotong

Objective:observe the changes of plasma content of endothelin and calcitonin gene-related peptide in embolization of intracranial aneurysms under intravenous anesthesia and the influence of continuous infusion Nimotong on endothelin and calcitonin gene-related peptide.Methods:32 patients undering selective embolization of intracranial aneurysms were randomly divided into two groups, nimotong group (N) and control group (C).After anesthesia induction, N group continued to infusing nimotong 2mg/h, C group continuous infusion normal saline 10ml/h both until the end of surgery. After induction, retrograde jugular vein catheter to the sigmoid sinus under DSA. Respectively, before and after endovascular embolization, taken blood from the sigmoid sinus test the plasma content of endothelin and calcitonin gene-related peptide levels and blood gas analysis, monitoring the average arterial blood pressure, and heart rate during five times:Into the operating room(Tl),after induction (T2),into the micro-catheter (T3),after embolization (T4),tracheal extubation (T5).Results:â‘ The change in the circulatory system:the heart rate of control group duing tracheal extubation, the heart rate faster than surgery, a statistically significant difference (P<0.05), patients with nimodipine during intraoperative heart rate more steady than control group, group comparison no significant difference (P> 0.05). Blood pressure, blood pressure groups within the T2 time period were lower than T1, the difference was statistically significant (P<0.01). Blood pressure groups within the T3 time period are lower than T2, the difference was statistically significant (P<0.01), and the reduction in the nimotong group was larger than that of the control group, the difference was statistically significant (P<0.05).In the control group, Blood pressure of T4 is higher than T3 period, the difference was statistically significant (P <0.01). The T5 time blood pressure in both group are higher than the time T4, the difference was statistically significant (P<0.01).â‘¡Blood gas analysis and electrolyte changes:Blood sugar in two groups after embolization are increased,the differences are statistically significant (P <0.05). PH, HCT, BE, HCO3 K in nimotong group after surgery are lower than before surgery, the difference was statistically significant (P <0.05).â‘¢ET and CGRP changes:both groups endothelin levels before the surgery were significantly increased.After surgery both group are decreased, the differences are statistically significant (P<0.01). After surgery calcitonin gene-related peptide in both groups are increased, the concentration change in the control group, was statistically significant (P <0 .01)Conclusion:â‘ Under the remifentanil and propofol anesthesia, intracranial aneurysm embolization reduced vasoconstrictor substance endothelin, and increased diastolic blood concentration of calcitonin gene related peptide material.â‘¡Under the remifentanil and propofol anesthesia, intracranial aneurysm embolization continuous infusing nimotong, vasoconstrictor substance endothelin did not significantly lower and not increased diastolic blood concentration of calcitonin gene related peptide material.