Antiinflammatory effect of sevoflurane in open lung surgery with one-lung ventilation
Antiinflammatory effect of sevoflurane in open lung surgery with one-lung ventilation
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DOI：
10.3325/cmj.2014.55.628
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发表时间：
2014-12-01
影响因子：
1.9
通讯作者：
Klokocovnik, Tomislav
中科院分区：
文献类型：
--
作者：
Potocnik, Iztok;Jankovic, Vesna Novak;Klokocovnik, Tomislav
目的 前瞻性评估挥发性麻醉剂七氟醚对接受单肺通气 (OLV) 开胸手术患者的抗炎作用。 方法 这项前瞻性随机研究纳入了 40 名接受 OLV 胸外科手术的患者 (NCT02188407)。患者被随机分为两组，分别接受丙泊酚或七氟醚治疗。四名患者被排除在研究之外，因为他们在手术后接受了输血或非类固醇抗炎药物。围手术期测量炎症介质（白细胞介素 6、8 和 10、C 反应蛋白 [CRP] 和降钙素原）。通过胸部 X 光检查评估未手术肺部的浸润情况并计算氧合指数。统计术后主要并发症。结果异丙酚组白细胞介素6水平显着高于七氟醚组(P=0.014)。术前各组间 CRP 水平没有差异（P = 0.351），所有患者均低于 20 mg/L，但异丙酚组术后 CRP 显着升高（31 +/- 6 vs 15 +/- 7 ng/L；P = 0.035）；两组术前、术后降钙素原均在参考范围内（<0.04μg/L）。丙泊酚组的氧合指数显着较低（339 +/- 139 vs 465 +/- 140；P = 0.021）。各组之间的肺浸润没有显着差异（P = 0.5849）。丙泊酚组术后不良事件发生率较高，但差异不显着（5 vs 1；P = 0.115）。 结论 本研究提示七氟醚对 OLV 开胸患者具有抗炎作用。
Aim To prospectively assess the antiinflammatory effect of volatile anesthetic sevoflurane in patients undergoing open lung surgery with one lung ventilation (OLV).Methods This prospective, randomized study included 40 patients undergoing thoracic surgery with OLV (NCT02188407). The patients were randomly allocated into two equal groups that received either propofol or sevoflurane. Four patients were excluded from the study because after surgery they received blood transfusion or non-steroid antiinflammatory drugs. Inflammatory mediators (interleukins 6, 8, and 10, C-reactive protein [CRP], and procalcitonin) were measured perioperatively. The infiltration of the nonoperated lung was assessed on chest x-rays and the oxygenation index was calculated. The major postoperative complications were counted.Results Interleukin 6 levels were significantly higher in propofol than in sevoflurane group (P = 0.014). Preoperative CRP levels did not differ between the groups (P = 0.351) and in all patients they were lower than 20 mg/L, but postoperative CRP was significantly higher in propofol group (31 +/- 6 vs 15 +/- 7 ng/L; P = 0.035); Pre-and postoperative procalcitonin was within the reference range (< 0.04 mu g/L) in both groups. The oxygenation index was significantly lower in propofol group (339 +/- 139 vs 465 +/- 140; P = 0.021). There was no significant difference between the groups in lung infiltrates (P = 0.5849). The number of postoperative adverse events was higher in propofol group, but the difference was not-significant (5 vs 1; P = 0.115).Conclusion The study suggests an antiinflammatory effect of sevoflurane in patients undergoing thoracotomy with OLV.