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Effect of sevoflurane preconditioning on inflammatory cytokines and oxygen radicals during one lung ventilation in patients with lung cancer

WANG Dong-xin;HOU Wen-jie;DIAO Shi-qi;KAN Hong-li;Department of Anesthesiology,Jilin Province Tumor Hospital;  
Objective To observe the effect of sevoflurane preconditioning on inflammatory cytokines and oxygen radicals during one lung ventlilation(OLV)in patients with lung cancer and to discuss the mechanism of sevoflurane induced lung protection.Methods Thirty patients,ASA ⅠorⅡ,with non-small-cell lung cancers underwent pulmonary surgeries were randomized into two groups:sevoflurance preconditioning group(group S,n=15)and control group(group C,n=15).After general anesthesia induction,a double-lumen tube was placed and the position was checked by a fibreoptic bronchoscope.During the mechanical ventilation,patients in group S,received sevoflurance at 1.0minimum alveolar concentration(MAC)for 30min as a preconditioning and then replaced by oxygen for a complete rapid gas exchange to reduce the sevoflurane inhalation concentration to 0before OLV.While in group C,only intravenous anesthetic agents,fentanyl and propofol,were administrated before OLV.Blood concentrations of TNF-a、IL-6、IL-8、SOD and MDA were measured at post-induction of anesthesia(T1),30min after OLV in the lateral position(T2),60min after OLV in the lateral position(T3),and at the end of the operation(T4).Results When compared with T1,the concentrations of TNF-α,IL-6and MDA in both groups and the IL-8in group S were significantly increased at T2-T4(P 0.05),while the expression of SOD in two groups were decreased significantly(P0.05).The concentrations of TNF-α,IL-6,IL-8and MDA in group S were decreased significantly at T2-T4(P0.05or P0.01)when compared with those in group C.The activity of SOD in group S was significantly increased at T3 and T4(P 0.05).Conclusion Sevoflurane preconditioning may moderate the release of inflammatory cytokines to inhibit the inflammatory reaction and may reduce the lipid peroxidation by inhibiting the generation of oxygen free radical.It may protect the lung from the injury during OLV.
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