Effects Of Sevoflurane And Desflurane Anesthetics Plasma Inflammatory Factors IL-6,TNF-a And S100B Protein In Patients With Intracranial Tumor Resection

Objective:This thesis is a tentative analysis of sevoflurane and desflurane’s cerebral protection effects to the intracranial tumor resection patients through the observations on the influence from the servoflurane and desflurane upon the plasma inflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-a (TNF-a) to the intracranial tumor resection patient within the perioperative period and the changes of S100B protein.Methods:Thirty patients undergoing selective brain tumor resection ASAI-Ⅱ were selected and randomly divided into two groups:sevoflurane group (group S)、 desflurane (group D), each group contained 15 patients. All the selective patients were monitored for blood pressure, heart rate, blood oxygen saturation, BIS. And had the radial artery and the right internal jugular venous puncture and catheterization as well as pulse pressure measurement under local anesthesia. Both groups adopted general anesthesia induction and had an intravenous cannulation of atropine 0.01mg/kg, midazolam 0.04 mg/kg, fentanyl 3 ug/kg, etomidate 0.3 mg/kg, rocuronium 0.6 mg/kg. In the operation, took sevoflurane and desflurane respectively, the two groups maintained MAC value at 1.0 and BIS value at 50±5, and pumped intravenous remifentanil 0.06-0.15ug/kg/min, and kept the haemodynamics been monitored.3ml central venous blood samples were taken respectively before the anesthesia induction (To), the cut of the dura mater of brain (T1), immediately after the removal of tumor (T2), after the operation complete(T3) and 24 hours after the operation (T4). The blood samples were transferred to a high-speed centrifuge for 5 min (4000r/min), then 1.0ml supernatant (plasma) was separated and put into EP (Eppendorf centrifuge tube) in a-80℃ refrigerator. And finally, the concentrations of TNF-a, IL-6 and the S100B protein in the sample plasma were tested with ELISA method (enzyme linked immunosorbent assay).Results:1-. The concentration of plasma IL-6:(1) intra-group comparisons: Group S:compared with To, IL-6 dropped significantly at T1、T2 and T3 (P<0.05), however, at T4, there was no statistical significance (P>0.05). Group D:compared with T0,IL-6 dropped significantly at T1、T2 and T3 (P<0.05), however, at T4, there was no statistical significance (P>0.05).(2)comparison among groups: There had no statistical difference in the concentration of IL-6 at T0-T4 between the two groups (P>0.05)2, The concentration of plasma TNF-a:(1) intra-group comparisons: Group S:compared with To, TNF-a dropped significantly at T1、T2 and T3 (P<0.05), however, at T4, there was no statistical significance (P>0.05). Group D:compared with T0,TNF-a dropped significantly at T1、T2 (P<0.05), however, at T4 and T3, there were no statistical significance (P>0.05).(2) comparison among groups: There was no significant differences in TNF-a at To and T4 between the two groups (P>0.05); at T2 and T3, the concentration of TNF-a of group D was higher than that of group S, which had statistical significance (P<0.05).3n The concentration of plasma S100B protein:(1) intra-group comparisons: Group S:compared with T0,S100B protein rose at T1 and T4, which had no statistical significance(P>0.05). However, at T2 and T3 it was statistically significant(P<0.05). Group D:compared with T0, at T2,T3 and T4 S100B protein increased significantly (P<0.05), but at T1, the difference was not statistically significant (P>0.05).(2)comparison among groups: There was no significant differences in S100B protein at T0-T3 between the two groups (P>0.05); at T4, the concentration of S100B protein of group D was higher than that of group S, which had statistical significance (P<0.05).Conclusion:1. The anesthesia maintained with sevoflurane and desflurane-remifentanil had achieved positive effects in cerebral protection and prognosis on patients with intracranial tumor resection through inhibition of plasma proinflammatory cytokines IL-6 and TNF-a.and alleviation of inflammatory response. No significant difference between the two plasma inflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-a (TNF-a).2、The two groups of patients with intracranial tumor resection showed damage of brain tissue when operation progressed and the concentration of plasma S100B protein was increased.3、From the concentration of IL-6,TNF-a and S100B protein, it appears that the cerebral protective effect of sevoflurane stronger than desflurane, but there was no significant difference between them.