Influence Of Penehyclidine Hydrochloride On Cerebral Oxygen Metabolism And S100B Protein Of Intracranial Aneurysm Clipping Surgery

Objective To investage the influence of penehyclidine hydrochlorideon cerebral oxygen metabolism and S100B protein of intracranial aneurysmclipping surgery.Methods Sixty patients of ASA I-II level undergoing electiveintracranial aneurysm surgery were randomly divided into three groups(20in each group): Penehyclidine Hydrochloride0.02mg/kg (group A),Penehyclidine Hydrochloride0.04mg/kg (group B) and nornmal saline as acontrol group (group C). All cases were under general anesthesia. GroupA and group B were given a corresponding dose of PenehyclidineHydrochloride at five minutes before the induction of anesthesia. Radialartery and left internal jugular bulb blood sample were collected forblood gas analysis at five minutes before temporary parent arterialocclusion (T1), five minutes after the blocking (T2), ten minutes afterthe blocking (T3) and ten minutes after the open parent artery. CaO2, CjvO2,D(a-jv)O2, CEO2, L(jv-a)and CLP were calculated according to Fick formula.Left internal jugular bulb blood samples were collected at five minutesbefore temporary parent arterial occlusion (T1), two hours after aneurismwas clipped (T5), four hours after aneurism was clipped (T6), twenty-fourhours after aneurism was clipped (T7) to measure the concentration ofserum S100B protein with ELISA.Results D(a-jv)O2and CEO2in group A and group B were significantlylower than group C at T2and T3(p<0.05), while group B was significantly lower than group A (p<0.05); L(jv-a) in group A and group B weresignificantly lower than group C at the time of T2, T3and T4(p<0.05);CLP in group A and group B were significantly lower than group C at T2and T3(p<0.05); L(jv-a) and CLP in group B was significantly lower thangroup A at T3(p<0.05)ï¼›three groups of S100B protein concentration at thetime of T5, T6, and T7were significantly higher than of T1, and reachthe peak value at T6(P<0.01), and the concentration was decreasing atT7but still higher than that of T1(P<0.01); at the time of T5, T6andT7, the S100B protein concentration of group A and group B were lower thangroup C (P<0.05), and the S100B protein concentration of group B was lowerthan that of group A (0<0.05).Conclusions1. Penehyclidine hydrochloride can significantly improvethe balance of cerebral oxygen supply and demand on Intracranial AneurysmClipping Surgery, and could reduce the level of serum S100B protein whichmay indicate a possibility of cerebral protection.2. Group B (0.04mg/kg) plays a more significant role than group A(0.02mg/kg) in cerebral protective function.