Preoperative Application Of Ibuprofen And Shenmai Injection On The Postoperative Cognition Of The Aged Rats

Background and PurposePostoperative cognitive dysfunction (POCD) is a common complication of central nervous system after anesthesia and operation. Generally believed that aging is the only definite independent risk factor. And the studies have found that anesthesia and surgery may be the main predisposing factors for triggering patients with POCD. The pathogenesis still remains unclear. In recent years, it has discovered stress-induced inflammatory reaction and the formation of POCD has a close relationship. In this experiment, the aged rats treated in preoperative drugs under the inhaled anesthetic isoflurane underwent the splenectomy. Then they were observed by behavioral experiments to study ibuprofen and Shenmai injection on the spontaneous activity and the ability of learning and memorizing at different times. And comparing the blood level of stress response in rats detected before and after surgery, brain hippocampal P-AP deposition, to assess that whether ibuprofen or Shenmai Injection exercises influence over postoperative cognitive function. Detecting biomarkers like the S-100protein, neuron specific enolase (NSE), to preliminarily assess of the situation of each experimental group in the early postoperative brain injury and neuronal damage.Method45healthy male aged SD rats screened with the experimental requirements, weighing500-600g, were randomly divided into three groups:control group (C group), Shenmai injection group (SMI group) and the ibuprofen group (I Group). All of them took the preoperative training of the Morris water maze and open field test, and were draw the jugular vein blood. Three days before the operation, Shen Mai injection was used by intraperitoneally injecting on the SMI group. And on the I Group, the rats were intragastric filled by ibuprofen. The operation was inducted of general anesthesia3%isoflurane anesthesia until the righting reflex disappears. Put its head into a homemade anesthesia box, and then maintain the conditions of2%isoflurane inhaled anesthesia, do resection of the spleen. The surgery lasted4h. Immediately after the operation, draw blood from the jugular vein. Postoperative lights and insulation to keep warm, and enhance nutrition.24h after the operation draw the blood, then measured them by the means of Morris water maze and open field test. On the3,7,21d, took them to do the morris water maze and open field test. On the1,3,7,21d after surgery, rats were randomly selected in10%chloral hydrate intraperitoneal anesthesia, taken the brain and fixed, immunohistochemical staining for expression of β-AP. Extraction of blood were tested for the content of ACTH, ALD, IL-1, IL-2, IL-6, TNF-aand the level of NSE, S-100content determination.Result1. The general situation of the experimental animals In all surgeries, the rats have stable vital signs, red lips and extremities parts, no body movement, hypotension, respiratory depression and signs of hypoxia, suggesting that the effect of the anesthetic was satisfactory. At the same time, the rats’months of age, weight and swimming speed indicated differences of statistical significance (P>0.05) eliminated relevant factors interfered with cognitive function.2. Changes in the behavior of aged rats2.1The behavior changes in the Morris water maze show that, on the first and third day after the surgery, the rats in the I group spended obviously shorter time to escape. And between the three groups, the average swimming speeds were not statistically different.2.2The open field results:on the next day after the operation, the total number, the erect across the case number and activity, the central in the two other groups all have obvious difference in statistical significance. 3. ELISA results:immediately after the operation was done, group Ⅰ and group C have significant differences in IL-1, IL-2, IL-6, TNF-α, ACTH, ALD, CORT, NSE, S100β. Group S serum IL-1, IL-6, TNF-αconcentration and group C corresponding index concentration has significant differences.Conclusion Preoperative use of ibuprofen can effectively suppress the occurrence of postoperative inflammation, to decrease the deposition of beta-amyloid in the brain and reduce the incidence of postoperative cognitive impairment.