Effects Of Sevoflurane Preconditioning On Pulmonary Function In Patients With One Lung Ventilation

Objective(s):The purpose of the study is to investigate the effect of sevoflurane preconditioning on pulmonary function in patients with one-lung ventilationMethods:According to the inclusion criteria,40 patients with lobectomy were selected and randomly divided into two groups:sevoflurane pretreatment group(S group,n=20)and propofol group(P group,n=20).After induction of tracheal intubation with general anesthesia,patients in group S were given 1 MAC of sevoflurane for pretreatment for 30 min,followed by cessation of sevoflurane and rapid oxygenation for gas exchange to ensure that the inhalation concentration was at the beginning of single lung ventilation Zero.Patients in group P were not pretreated with sevoflurane.The remaining anesthetic regimens were the same in both groups.Two groups of patients before induction of anesthesia(T0),15min after ventilation of lateral lungs(T1),30min after ventilation of one lung(T2),30min after recovery of ventilation of both lungs(T3),60min after recovery of ventilation of both lungs(T4),postoperative 6h(T5)and postoperative 48h(T6)of the patient’s arterial blood samples,anticoagulation by adding heparin,centrifugation at 3000r/min for 10 minutes,separation of plasma at-20℃ for storage,after all specimens were collected,Enzyme-linked immunosorbent assay(ELISA)for determination of CC-16 protein concentration in patient plasma.At the same time,arterial blood gas analysis was performed at the time points of T1,T2,T3,and T4,and PaO2 was recorded to calculate the oxygenation index(OI)of the patient.Follow-up and recording of postoperative adverse events,including postoperative pulmonary infection,systemic inflammatory response syndrome,sepsis,and in-hospital mortality.Results:There was no significant difference(p>0.05)in gender,age,ASA rating,type of surgery,single lung ventilation time,and operation time between the two groups.Compared with T0,plasma CC-16 levels in both groups increased at different time points at T2,T3,T4,T5,and T6(p<0.05);compared with P group,S Plasma CC-16 levels in the group of patients did not differ at T0 and T1 time points,but were significantly lower at T2,T3,T4,T5,and T6 time points(p<0.05).Compared with the T1 time point,the oxygenation index of the two groups decreased to varying degrees at the T2,T3,and T4 time points(p>0.05);the oxygenation index of the S group was higher than that of the P group.There was no difference in T1 time points,but it was significantly lower at the T2 and T3 time points(p<0.05).There was no significant difference between the two groups at the T4 time point.In terms of postoperative outcomes,there was no difference in postoperative pulmonary infections,systemic inflammatory response syndrome,hyperlipidemia,and in-hospital mortality.Conclusion(s):Pretreatment with sevoflurane can significantly reduce plasma CC-16 levels in early postoperative patients with lung ventilation,improve early postoperative oxygenation,and have a protective effect on early postoperative lung function.The long-term effect is still not clear,and it needs to be further studied.