Effects of propofol and remifentanil on S100β and NSE in patients with aneurysm clipping

WANG Haiyan; LU Yanbin; DU Jianlong; JIANG Liuqin; LEI Guodong; GAO Huaixin; ZHANG Jun; ZHANG Afeng; LIANG Guoqing; JIN Le; HUANG Haiyan

Abstract：Objective The effects of propofol and remifentanil on blood flow metabolism and serum levels of S100β and neuron-specific enolase (NSE) in patients with anterior aneurysm clipping were discussed.Methods Fifty-six patients undergoing occlusion of intracranial aneurysm under general anesthesia were divided into two groups according to ASA Grade Ⅰ or Ⅱ.They were randomly divided into two groups by random number table method with 29 cases in the treatment group and 27 cases in the control group.The patients in the treatment group were given propofol plus remifentanil to maintain anesthesia and for those in the control group propofol were given.Total intravenous anesthesia was maintained at various depths.The hemodynamic changes were detected at the duration of intubation (t0),dural incision (t1),aneurysm occlusion (t2),aneurysm occlusion immediately (ts),and end of surgery (HR),respectively,and the indices including mean arterial pressure (MAP),blood oxygen saturation (SpO2),arterial oxygen pressure (P02),internal jugular vein oxygen saturation (SjvO2),lactic acid concentration (La),lactate concentration (Ljv),dynamic and venous blood lactic acid concentration difference (DLjv-a) were recorded.A total of 5 mL peripheral blood venous blood of two groups were synchronously drawn to detect the NSE levels and serum S100β protein by enzyme-linked immunosorbent assay (ELISA).Results The blood pressure (BP) and HR of the treatment group were significantly lower than those of the control group at t0,t1 and t2 (P ＜0.05).The content of internal jugular bulb oxygen content difference (Da-jvO2) was increased significantly compared with the control group and SjvO2 was significantly decreased at t3 and t4.However,the hemodynamic status maintained stable at all time points,and the fluctuation range was smaller than those of the control group.S100β protein and NSE levels were significantly lower than those in the control group (P ＜ 0.05).Conclusion Propofol combined with remifentanil can improve the blood rheology and increase the cerebral oxygen content in patients with aneurysm clipping,reduce the blood S100β protein and NSE content,decrease the nerve damage,accordingly play a role in brain protection.