Effect Of Edaravone On Oxidative Stress And POCD In Elderly Patients Undergoing Spinal Surgery

Objective To explore the effect of edaravone for improving oxidative stress and early postoperative cognitive dysfunction by measuring and analyzing the concentration levels of serum malondialdehyde(MDA),superoxide dismutase(SOD),S-100?protein and the incidence of early postoperative cognitive dysfunction in elderly patients undergoing general anesthesia spinal surgery.Methods Thirty elderly patients undergoing general anesthesia spinal surgery were selected from June 2017 to December 2017,ASA ?~?,aged 65 to 70 years old,and weighing 19-23 kg/m~2.Using a random number table method,the patients were divided into two groups:the edaravone group(group E)and the control group(group C).15 cases were in each group.All patients were selected for the first time for spinal surgery.There were no significant liver,kidney,blood,and mental disorders before surgery.30 minutes before the induction of anesthesia,group E was given 30 mg of edaravone and 100 ml of physiological saline intravenously;group C received the equal saline intravenously,and both groups were infused within 20 minutes.The other medications and doses in the group E were the same as those in group C.Do not use inhaled anesthetics during surgery.Blood samples were taken through peripheral vein at the following time points:before induction of anesthesia(T0),the beginning of surgery(T1),6h post-surgery(T2),24 h post-surgery(T3),72 h post-surgery(T4).Serum MDA?SOD and S-100?proteins were assayed by the TBA,hydroxylamine method and ELISE.In addition,to score the patients' cognitive function by using the Mini-Mental State Examination Scale(MMSE)at the following time points:before induction of anesthesia,6h post-surgery,24 h post-surgery,72 h post-surgery and 7t post-surgery.We used SPSS20.0 statistical analysis software to analyze the data.Results 1 The general conditions were not significantly different in between the two groups of patients.2 The scores of MMSE at 6,24,and 72 hours after surgery in group E and group C were significantly lower than those before surgery(P<0.05).The MMSE scores at 24 and 72 hours after surgery in group E were significantly higher than those in group C(P<0.05).The MMSE scores on the 7 days after the surgery were lower than before in the two groups,but the difference was not statistically significant(P>0.05).3Compared with T0,group C and group E in MDA at T1~T4 were significantly increased(P<0.05);Compared with group C,group E in MDA were decreased at T1~T3 and there were significant differences(P<0.05).4 Compared with T0,group C and group E in SOD at T1~T4 were significantly increased(P<0.05);Compared with group C,group E in SOD were increased at T1~T3 and there were significant diffrences(P<0.05).5 Compared with T0,group C and group E in S-100?protein at T2~T4 were significantly increased(P<0.05);Compared with group C,group E in S-100?protein were decreased at T2~T4 and there were significant differences(P<0.05).Conclusion Edaravone applicated in the elderly patients undergoing general anesthesia spinal surgery can eliminate excessive free radicals,inhibit the oxidative stress response,at the same time can reduce the concentration of serum S-100?protein associated with brain injury and then improve the early postoperative MMSE cognitive function score.It plays a positive role in improving early postoperative cognitive dysfunction in the clinic.