The Effects Of Different Anaesthetic On Oxidative Stress In Patients Undergoing Endovascular Treatment Of Intracranial Aneurysm

Objective: In this study to compare the effects of different anesthetic on oxidative stress in patients undergoing endovascular treatment of intracranial aneurysm.Methods: 120 cases of patients under general anesthesia were accepted endovascular treatment of intracranial aneurysm, The selected patients were randomly assigned to 2 groups: propofol group and sevoflurane group, each group had 60 cases. The general anesthesia has been used and the antioxidant drugs have been deactivated in the week before treatment. All patients were given midazolam 0.06~0.1mg/kg,sufentanil 0.2~0.4?g/kg, propofol 1.0~2.0mg/kg, rocuronium 0.6mg/kg during in anesthesia induction. In order to decrease the intubation responses and increase the one-time intubation success rate, Some patients who had evaluated difficult airway were intubated with glidescope. After intubation, all patients were treated with mechanical ventilation. Set the anesthesia machine parameter VT 6~10ml/kg, RR 12~16/min, I:E 1:2, PetCO2 30~35mmHg,Patients in propofol group were given propofol 2~4?g/ml by target-controlled infusion and remifentanil 0.1~0.2?g/kg·min,Patients in sevoflurane group were inhaled sevoflurane between 1.0~2.0 MAC, rocuronium 0.2~0.3mg/kg per 40 min.BIS 46-55.Infudion fluid were sodium lactate ringer's and hydroxyethyl starch 130/0.4. Vasoactive drugs such as atropine, noradrenaline, esmolol were used to maintain the patients hemodynamic stable as needed. Half an hour before the end of treatment, stopped using rocuronium. After finishing the treatment, stopped using propofol and sevoflurane. When the patients resumed breathing without the support of the machine, they were extubated and then send back the ward. The Glasgow coma Score(GCS) were recorded before the anesthesia. The heart rate and mean artery pressure were recorded during the operation. The activity of malondialdehyde(MDA), superoxide dismutase(SOD), catalase(CAT) and glutathione peroxidase(GSH-Px) were measured at the time points of pre-anesthesia(T0), post-operation 6 hours(T1), 24 hours(T2), 48 hours(T3)and 72 hours(T4). The efficacy of anesthesia was evaluated by Glasgow Outcome Score(GOS) after operation 3 months. The SPSS16.0 statistical software was used for statistical analysis, count data were present as percentage(%), and measurement data were presented as mean ± standard deviation, the measurement data using a randomized block design ANOVA, and repeated measures design, the measurement data using analysis of variance, measurement data using chi-square test.Results: 2 groups were comparable in general data(age, weight, HP, ASA, GCS, HR, MAP),with no significant difference(P>0.05). The MDA concentrations were higher at T2, T3, T4 than at T0 in 2 groups(P<0.05). The activity of superoxide dismutase, catalase and glutathione peroxidase in 2 groups were lower at T2 and T3 than at T0(P<0.05). At T1, T2, T3, T4, the superoxide dismutase activities of propofol group were higher than that of sevoflurane group(P<0.05), and at T1 and T2 catalase activities were higher than that of sevoflurane group(P<0.05), at T1, T2, T3 similar to the glutathione peroxidase activities were higher than that of sevoflurane group(P<0.05). The outcome of neurosurgery had no significant differences between the 2 groups(P>0.05).Conclusions: Both 2 kind of anesthetics could reduce the effect on oxidative stress. Comparing with the sevoflurane group, the patients with propofol anesthesia could reduce more the effect on oxidative stress with intracranial aneurysm undergoing interventional operation.