Pulmanary Protection Of Edaravone On Patients Undergoing Thoracoscopic Upper Lobectomy

Objectives To observe the effects of edaravone on the inflammatory response and oxidative stress in patients undergoing thoracoscopic upper lobectomy,in order to explore the protective effect of edaravone on the lungs.Methods Sixty patients undergoing thoracoscopic upper lobectomy were randomly divided into two groups,control group?n=30?and edaravone group?n=30?.Thirty minutes before anesthesia induction,100 ml normal saline was injected intravenously in patients of group C,and intravenous injection of 30 mg edaravone?dissolved in 100 ml normal saline?in patiedts of group E,thirty minutes before anesthesia induction.Infusions of both groups were completed within thirty minutes.5ml of the artery anticoagulant blood was collected at four time points as follows:before intravenous infusion of edaravone or normal salin?T0?,immediately before one lung ventilation after anesthesia induction?T₁?,with single lung ventilation right for thirty minutes?T₂?,and sixty minutes with two lung ventilation right afte the lobectomy?T₃?,of which 1ml was used for blood gas analysis and 4ml for centrifugation and then stored in refrigerator at-80?.We use the blood gas analyzer to test the arterial blood gas index--pH?PCO2?PAO2 and D?A-a?O2.The concentration levels of serum interleukin-8?IL-8?,interleuk-10?IL-10?,tumor necrosis factor alpha?TNF-??and alveolar surfactant associated protein-A?SP-A?were measured by enzyme-linked immunosorbent assay?ELISA?,and the concentration levels of superoxide dismutase?SOD?was measured by colorimetric method.Take a piece of lung tissue out of the operative side,and then observe the histopathological changes under high-power fiberscope?×100?after HE staining.Results 1 There was no significant difference in general condition indexes between the two groups?P>0.05?;2 At T₂ and T_3,there were significantly higher D?A-a?O₂ in both groups?P<0.05?,but the level in group C was much higher than that in group E?P<0.05?;3 The concentration levels of serum IL-8?IL-10 and TNF-?in both groups increased significantly with the prolongation of operation time?P<0.05?,the concentration level of IL-8?TNF-?in group C was significantly higher than that in group E?P<0.05?,the concentrantion level of IL-10 in group E was significantly higher than that in group C?P<0.05?;4 The concentration levels of serum SOD in group C decreased significantly with the prolongation of operation time?P<0.05?,the concentration levels of serum SOD in group E increased significantly with the prolongation of operation time?P<0.05?;5 The concentration levels of serum SP-A in both groups increased significantly with the prolongation of operation time?P<0.05?;the concentration level of SP-A in group C were significantly higher than those in group E at T₂ and T₃?P<0.05?;6 The pathological tissues of the twos showed inflammatory reaction under higher power microscope,and the reaction in group C was more serious than that in group E.Conclusions Edaravone can reduce the production of inflammatory factors and increase the elimination of oxygen free radicals in the body,as a result alleviates the systemic inflammatory response and oxidative stress,and thus mitigating the degree of lung injury.Therefore,it has certain protective effect on the lung of the patients undergoing thoracoscopic upper lobectomy.