ABSTRACT
Objective To explore the neuroprotective mechanism of propofol by comparing the influence of propofol and isoflurane on inflammatory cytokines ( TNF-α、IL-1、ICAM-1 ) in patients with intracranial tumors. Methods One hundred and sixty-eight patients with intracranial neoplasm were randomly divided into two groups:the propofol ( Group P) and isoflurane (Group I),84 cases in each. Patients were given with propofol (3-6 μg·mL-1) by plasma target-controlled infusion or with continuously inhaled isoflurane ( 1%-2%) , respectively. The serum levels of TNF-α, IL-1 and ICAM-1 were detected before anesthesia and at 0,24,and 48 h after operation. Results The serum levels of TNF-α,IL-1 and ICAM-1 were significantly increased after operation as compared to baseline in both groups. The serum level of TNF-α was(69. 11±8. 95) and (76. 26±11.28) μg·mL-1,IL-1 was(21.57±3.19) and (29.58±4.38) ng·L-1,and ICAM-1 was (1.63±0.24)and (1.94±0.29) g·L-1 at 24 h post operation in Group P and Group I,respectively. These inflammatory cytokine levels were significantly higher in group I compared to group P at 24 and 48 h after operation (P<0. 05 or P<0. 01). Conclusion The target-controlled infusion of propofol brings about lower level of inflammatory reaction than isoflurane inhalation in patients with intracranial neoplasm,which may attribute to the mechanism of brain protection against injury.
ABSTRACT
Sevoflurane is a widely used volatile anesthetic agent, but the simple efficacy of sevoflurane in cardio protection is unknown. This systematic review assesses the effect of sevoflurane in myocardial protection during coronary artery bypass graft surgery. An electronic search was undertaken, without language restriction, from MEDLINE, EMBASE, and CENTRAL. All relevant randomized controlled trials of adult cardiac patients undergoing coronary artery bypass grafting surgery which involved in sevoflurane were included. Exclusion criteria were duplicate publications and lack of outcome data. The outcome measures were cardiac troponinI serum concentration, myocardial infarction, and death. Statistical heterogeneity and inconsistency of each outcome were detected. Publication bias was measured through visual inspection of funnel plots of the outcomes.Twenty eligible randomized clinical trials were identified, with 1,912 patients. Thirteen studies, with 759 patients, reported 8a significant reduction in cardiac troponin Iserum concentration [P < 0.0001]. There was no significant difference between sevoflurane and control with respect to myocardial infarction [P = 0.23, 14 studies, 1,395 patients] and mortality [P = 0.36, 15 trials, 1,465 patients]. This study has shown the evidence of sevoflurane protection in coronary artery bypass graft surgery, with a down regulation in troponin I
ABSTRACT
Objective:To compare etomidate in propylene glycol(Eto-PG) with a new galenic preparation of etomidate solved in a lipid emulsion of soya-bean oil(Eto-Lip).Method:Sixty patients were randomly divided into 2 groups:Eto-PG group and Eto-Lip group.The dosage of etomidate was 0.3mg/kg.Hemodynamic change and side effects(pain on iv-injection,involuntary movement, phlebitis, thrombophlebitis etc.) were observed.Result:There were no difference between the two groups in the incidence of involuntary movement.Side effects at the site of injection,both immediate and after operation,were encountered with Eto-PG but were not encountered in the lipid emulsion. Conclusion:Eto-Lip can reduce some undesired side effects without changing its pharmacodynamics.