RESUMO
Objective To investigate effects of inhalation of sevoflurane at different time on pulmonary function and oxidative stress in patients with one lung ventilation.Methods 80 patients who needed external surgery according to the random grouping principle,were divided into sevoflurane preconditioning group(OLV for 30min after inhalation of sevoflurane),sevoflurane treatment group(OLV inhalation of sevoflurane),sevoflurane inhalation group(inhalation of sevoflurane),total intravenous group(propofol and remifentanil anesthesia) four groups,20 patients in each group,each group was treated accordingly.The differences of serum malondialdehyde(MDA),superoxide dismutase(SOD),lactate dehydrogenase(LDH) and intrapulmonary shunt(Qs/Qt) in the four groups were observed and compared at different time points.Results Compared with the other three groups,the intrapulmonary shunt fraction of the sevoflurane preconditioning group were significantly lower[(4.9±0.6)% vs.(6.1±0.5)%,(6.3±0.6)%,(5.9±0.4)%](x2=5.415,5,882,4.977,all P<0.05).The serum levels of MDA,SOD,LDH in the sevoflurane pretreatment group were significantly lower than those in the other three groups[(5.06±2.10)nmol/mL vs.(13.04±3.27)nmol/mL,(12.40±4.28)nmol/mL,(13.13±2.30)nmol/ml],[(58.7±5.9)U/L vs.(84.9±13.8)U/L,(93.9±21.1)U/L,(84.2±11.2)U/L],[(16.3±2.1)U/L vs.(43.1±7.2)U/L,(45.4±6.7)U/L,(35.8±5.1)U/L](t=8.076,7.448,8.277;12.917,15.506,12.586;11.375,12.239,8.220,all P<0.05).Conclusion Thoracic surgery in patients with one lung ventilation during anesthesia,using sevoflurane preconditioning anesthesia surgery can effectively improve the patients with intrapulmonary shunt rate,reduce the level of oxidative stress and improve the prognosis,it is worthy of further clinical application.
RESUMO
Objective To investigate the effect of sevoflurane intravenous inhalational anesthesia and remifentanil intravenous anesthesia for single lung ventilation in the department of thoracic surgery operation .Methods 80 patients using thoracic surgery were randomly divided into the two groups with 40 cases in each group according to the number table methods ,the study group were treated with sevoflurane inhalation anesthesia while the control group were treated with remifentanil intravenous anesthesia .HR,MAP and SBP of the two groups before induction of anes-thesia(T0),1min before intubation(T1),10min after ventilation(T2),30min after ventilation(T3) and 1min before extubation(T4) were compared,and recovery time,extubation time,directional force the recovery time were recorded of the two group.Results The HR in the two groups at T1,T2,T3,T4 time did not change significantly than T0 time, while MAP decreased significantly than T0 time,with significant difference (t =8.12,7.82,8.14,8.05,all P 0.05);The SBP in the study group did not change obviously at each time while the SBP in the control group at T 1 decreased significantly than T0 time,while it increased significantly at T 2 time than T1 time,with a significant difference ( t=10.51,5.34, 5.05,5.06,all P<0.05);The patients in study group were elevated blood pressure during anesthesia or decreased more than 30% occurred in 8 cases while the control group occurred in 24 cases,there was significant differences between the two groups (χ2 =13.33,P<0.05);The postoperative recovery time ,extubation time and orientation recovery time of the study group patients were (11.4 ±5.1)min,(13.4 ±6.8)min,(18.9 ±5.8)min,which were significantly lower than (19.5 ±5.2)min,(26.5 ±7.6)min,(21.9 ±7.8)min of the control group(t=5.34,6.12, 6.15,all P<0.05).Conclusion Sevoflurane intravenous inhalational anesthesia has a better anesthetic effect for single lung ventilation in the department of thoracic surgery operation than remifentanil intravenous anesthesia ,and it can effectively maintain hemodynamics stability .