Changes of nitric oxide and protective effects of propofol during neurosurgical anesthesia in patients with acute cerebral injury

doi:10.3969/j.issn.1002-1949.2001.04.006

Abstract：Objective To investigate the effects of propofol(Pro) on theplasma contents of nitric oxide (NO),nitric oxide synthase activity(NOS),oxygen free radical(OFR),lipid peroxides(LPO),endothlin(ET) and calcitonin gene related peptide(CGRP) in perioperative patients during neurosurgery.Methods Forty patients with acute cerebral injury(ACI) were divided randomly into receive propofol anesthesia and α-OH as control.Anesthesia was induced with fentanyl,Droperidol,Etomidate and sucinycholine.In Pro group anesthesia was maintained with Pro 6～9 mg/(kg·h), and in control group anesthesia was maintained with α-OH 60 mg/kg. Anesthesia were complex with tramal,Atracurium introvenously.Plasma samples were drawn before anesthesia to 1,3,6,12,24 hours (T0～T5）.Results NOS activity,OFR,LPO,ET were significantly increased before operation in patients with brain tumor or ACI compared to normal value.Compared to control group,propofol group NOS activity (T2～T5)and NO (T3～T5) were significantly decreased compared to T0.Conclusions There are OFR metabolism disorder in patients with ACI before operation.Surgical procedures on the brain may induce secondary cerebral ischemia Therapeutic dose of propofol treated may significantly inhibit that NOS activity and act as an OFR scavenger.Pro markdly antagonistic effect to ET in vivo and increase CGRP level.Possess cerebral protective effect in many ways.