The effect of different anesthesia methods on the oxidative stress reaction in elderly patients with lobectomy / 中国医师进修杂志

ABSTRACT

Objective To observe the influence of the oxidative stress reaction in elderly patients with lobectomy under epidural blockade combined with either propofol or sevoflurane.Methods Sixty elderly patients with lobectomy were enrolled in this study,ASA Ⅰ-Ⅲ grade.The patients were divided into propofol combined with epidural blockade group (group P,30 patients) and sevoflurane combined with epidural blockade group (group S,30 patients) by random digits table method.The depth of anesthesia in group P was kept by 40-50 μ g/ (kg ·min) propofol and in group S was kept by 1％-2％ sevoflurane continuous inhalation.The level of malondialdehyde (MDA),nitric oxide (NO),superoxide dismutase (SOD),glutathione peroxidase (GSH-Px) in two groups before surgery (T0),one lung ventilation (T1),2 h during surgery (T2),surgery end (T3),2 h postoperatively (T4) and 24 h postoperatively (T5) in venous blood were detected and compared.Results The level of systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart rate (HR) at T2 was significantly decreased compared with T0 in two groups (P ＜ 0.05).The level of SBP,DBP and HR at every point had no significant difference between two groups (P ＞ 0.05).The level of NO and MDA were increased at T1,T2 in group P and T1-T5 in group S compared with T0,the level of SOD and GSH-Px at T1-T5 in group S were decreased compared with T0,there were significant differences (P ＜0.05).The level of NO and MDA at T3-T5 were decreased and the level of SOD and GSH-Px were increased in group P compared with those in group S,there were significant differences (P ＜0.05).Conclusion Propofol can reduce the oxidative stress reaction more effectively comparing with sevoflurane,and has some help on the prognosis of the elderly.