Sevoflurane Preconditioning Mitigates Oxidative Stress Injury Induced By One-Lung Ventilation In Patients With Pulmonary Lobectmy

Background As one lung ventilation in thoracic surgery in the wide application, lung injury induced by one-lung ventilation is also to the further research gradually. Sevoflurane is at present commonly used in clinical general anesthesia, which has attracted much attention in recent years because of its organ protection. Sevoflurane pretreatment can produce similar ischemia preconditioning organs protection effect, and the specific mechanism needs to be further discussed. Malondialdehyde (MDA) content can be reflected in the lipid peroxidation and indirectly reflect the extent of oxygen free radical attacks by cells of serious degree; Super oxide dismutase (SOD) the discretion of the activity may reflect the body scanvenge oxygen free radicals ability; Heme oxygen enzyme-1(HO-1) is important endogenous protection protein, and is a reflection of the most sensitive cells oxidative damage indexes.Through the observation of HO-1level of Surgery side lung tissue, serum MDA concentration, the serum SOD level, this paper discusses the influence of sevoflurane pretreatment on one-lung ventilation which induce lung oxidative stress and its lung protection of patients underwent pulmonary lobectomy.Object Thirty patients, ASA Ⅰ or Ⅱ, aged40to60years, weighting50to75Kg, scheduled for pulmonary lobectomy, were randomized into group propofol total intravenous anesthesia (group P) and group sevoflurane preconditioning (group S), with15cases for each. In group S, before one-lung ventilation, the patients were inhaled1to2%sevoflurane for30min, as a simulation of sevoflurane preconditioning; while in group P, patients was supplied propofol total intravenous anesthesia at the same period time.Immediately before one-lung ventilation (T1), immediately on the end of one-lung ventilation (T2),30min after one-lung ventilation (T3), respectively,4ml cubital venous blood samples were collected in order to determine the level of serum malondialdehyde (MDA) and superoxide dismutase (SOD). The contents of heme oxygenase-1in normal lung tissue of removal pulmonary lobe were detected. One milliliter radial artery blood samples were collected for measuring oxygenation index (PaO2/FiO2) at2h after surgery.Results Hemodynamic parameters were kept stable throughout in both groups. The contents of HO-1of removal lung tissue were significantly higher in group S than in Group P (P<0.05). At the time point of T3, the content of serum MDA was significantly lower in group S than in group P (P<0.05),while the activity of SOD was increased significant compared with group P. At2h after surgery, the oxygenation index (PaO2/FiO2) were significantly higher in group S than in group P (P<0.05)Conclusions One-lung ventilation will cause oxidative stress injury in lung tissue and sevoflurane preconditioning can reduce oxidative stress by inducing the increasing expression of HO-1in lung tissue.