Neuroprotective Effects Of Dexmedetomidine During Brain Tumor Resection

Objective To observe the effect of hemodynamics and the dynamic change of NSE, S100B protein,investigate neuroprotective effects of Dexmedetomidine(DEX) combined Isoflurane during brain tumor resection.Methods Forty patients(ASA II)undergoing selective brain tumor resection were randomly divided into two groups(n=20):DEX group(group D),propofol group (group P). Group D received DEX1μg/kg by infusion before induction.Induction of anesthesia were given midazolam0.1mg/kg, fentany4μg/kg, cisatracurium0.2mg/kg, etomidate0.3mg/kg.During the operation,we using propofol, DEX, cisatracurium and Isoflurane to make vital sign steady.BIS values and hcmodynamic index, such as HR, SBP,DBP were recorded at the time points of preinduction(T0),cuting open the pachymeninx(T1),removing the tumor (T2), operation completion (T3),24hour after operation (T4). Human Soluble protein-100B(S100B)and neurone specific enolase (NSE)were measured at same time-points respectively. The OAA/S score after extubation10min and the VAS score after operation24hour were recorded.Result (1) S100B:There was no significant differences in S100B at T0,T1and T2between the two groups(P>0.05);S100B in group D at T3and T4was lower than that in group P(P<0.05). Compared with T0,S100B in two groups at T1showed no differences(P>0.05).There was a increase in S100B at T2,T3and T4compared with that at T0in two groups.(P<0.05).(2) NSE: There was no significant differences in NSE at To and T1between the two groups(P>0.05);NSE in group D at T2,T3and T4was lower than that in group P(P<0.05).Compared with To NSE in two groups at T1showed no differences(P>0.05).There was significant increase of NSE at T3, T4in two groups compared with that at To (P<0.05).(3) HR, SBP, DBP at T1,T2andT3in group D was lower than that in group P (P<0.05).(4) The wakeup time and extubation time in group P was longer than that in group D(P<0.05). The OAA/S score after extubation10min of D groups were higher than the P groups (P<0.05). Extubation qualities of D groups were also better than the P groups. The VAS score of D groups was less than that of group P (P<0.05)Conclusion Dex compound Isoflurane provided satisfactory anesthesia and stabilization of hemodynamic during brain tumor resection and provided better neuroprotective effects on patients, which is related to the decrease of S100B protein and NSE.