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The Effect of Sevoflurane, Isoflurane, Enflurane in General Anesthesia of Liver Cancer Patients and Induced Apoptosis of HepG2 Cells Cultured in Vitro

Author: MaHe
Tutor: RuanLin
School: Guangxi Medical University
Course: Anesthesiology
Keywords: Sevoflurane Isoflurane Enflurane HepG2 Apoptosis Resection of Liver Cancer Liver function
CLC: R965
Type: Master's thesis
Year: 2011
Downloads: 39
Quote: 1
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Abstract


Objective: To study sevoflurane, isoflurane and enflurane on cultured HepG2 cell apoptosis. Methods: divided into four groups according to the concentration of the groups administered concentrations were 1,10,20,30 times alveolar minimum effective concentration (MAC) when plasma concentration in HepG2 cells administered after 24h inverted microscope under morphological changes were observed; PI staining, flow cytometry determination of sevoflurane, isoflurane, enflurane HepG2 human hepatoma cell apoptosis rate. Results: Flow cytometry measurement apoptotic index order administration concentration (0.46 ± 0.21)%, (0.52 ± 0.10)% and (1.15 ± 0.32)% (sevoflurane), (0.63 ± 0.09)%, ( 0.69 ± 0.13)%, (1.39 ± 0.47)% (isoflurane), (0.51 ± 0.07)% and (0.42 ± 0.11)%, (0.62 ± 0.29)% (ex halothane), control blank group apoptosis index (0.37 ± 0.17)%. Compared with the control group, 10MAC 20MAC two concentrations of sevoflurane, isoflurane, enflurane role in HepG2 cells after 24h, no statistical significance (P gt; 0.05); concentration of sevoflurane 30MAC, isoflurane enflurane role in HepG2 cells 24 h after sevoflurane and isoflurane group increased the proportion of apoptotic cells (P lt; 0.05). Conclusion: The high concentration of sevoflurane and isoflurane can induce in vitro cultured HepG2 cells apoptosis, enflurane on cultured HepG2 cells had no effect. The second part of sevoflurane, isoflurane and enflurane on liver cancer patients liver function Objective: To observe sevoflurane, isoflurane and enflurane in patients with liver cancer resection. Methods: 80 cases of ASA Ⅰ ~ Ⅱ grade elective resection of liver cancer patients were randomly divided into four groups: sevoflurane group (S1), (S2 group) isoflurane group, enflurane group (S3 group) and control Group C propofol group (P group), 20 patients in each. S1, S2, S3 line sevoflurane, isoflurane and enflurane inhalation anesthesia, the P group row propofol intravenous anesthesia. Burglary monitor heart rate (HR), blood pressure (BP), respiration (R0), opened intravenous infusion after induction of anesthesia. Anesthesia was induced with, respectively, followed by intravenous injection of midazolam 0.1mg / kg, propofol 1.5mg/kg vecuronium 0.12mg / kg the fentanyl 3μg/kg, fentanyl intravenous finished 3 minutes tracheal intubation. Maintain anesthesia in each group were applied sevoflurane, isoflurane and enflurane 1-2MAC, control group adjusted according to hemodynamic propofol dose and calculated dose of propofol, vecuronium to maintain muscle relaxants. Each group of patients from the induction of anesthesia, observed and recorded tracheal intubation in patients Sui conditions, recorded before anesthesia (baseline), after induction, after intubation, 1 min, 3min, 5min, l0min skin incision, 30 min after incision 60min, 120min, the end of surgery, when you wake up, before extubation, after extubation, 1 min, 5min, l0min, 20min, 30min MAP, HR. Observed and recorded the use of vasoactive drugs during anesthesia, spontaneous respiration recovery time, recovery time, extubation time and postoperative complications. Were before anesthesia (T1), postoperative 1d (T2), postoperative 5d (T3), postoperative 10d (T4) and postoperative 20d (T5) 5 time points venous blood 5 mL determination of alanine aminotransferase ( ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL), total protein (TP), albumin (ALB) level. Results: The comparison between the four groups, sevoflurane, isoflurane and enflurane group and propofol group patients vital signs and postoperative liver function was no significant difference. Conclusion: Sevoflurane, Isoflurane and ex halothane used in liver resection satisfactory anesthesia.

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