Cerebral protective effect of nicorandil premedication on patients undergoing liver transplantation  

作　　者：Yun-Fei Xia,Zheng-Ping Wang,Ya-Chun Zhou,Tao Yan and Shi-Tong Li Department of Anesthesiology, Shanghai First People’s Hospital, Medical College, Shanghai Jiaotong University, Shanghai 200080, China 

出　　处：《Hepatobiliary & Pancreatic Diseases International》2012年第2期132-136,共5页国际肝胆胰疾病杂志（英文版）

基　　金：supported by a grant from the Shanghai Clinical Medical Center of organ transplantation(QY040101-2-04)

摘　　要：BACKGROUND:Neurological injury is a common complication in the early period after liver transplantation,posing an enormous obstacle to treatment efficiency and patient survival.Nicorandil is a mitochondrial ATP-sensitive potassium channel(mitoK ATP) opener.It has been reported to be effective in reducing brain injury in recent studies.However,it is still unclear whether nicorandil has cerebral protective effect in patients undergoing liver transplantation.METHODS:Fifty patients scheduled for liver transplantation were randomly divided into a nicorandil group(group N)(n=25),in which patients received 10 mg nicorandil through a nasogastric tube 30 minutes before induction of anesthesia,and a control group(group C)(n=25) who received 10 mL normal saline.The Mini-Mental State Examination(MMSE) was performed before anesthesia(day 0),and on days 3 and 7 after surgery.Blood samples were obtained before induction of anesthesia(T1),and at 12(T2) and 36 hours(T3) after surgery for determination of serum neuron-specific enolase(NSE) and S100β protein(S100β) concentrations.RESULTS:During surgery,5 patients in each group were eliminated due to severe reperfusion or renal insufficiency.Therefore,20 patients remained in each group.The MMSE scores after operation were significantly lower than those before operation in group C.However,there was no difference at days 3 and 7 compared with day 0 in group N.Serum NSE concentrations after surgery were significantly higher than baseline(at T1) in both groups,except at T3 in group N.Serum S100β concentration after surgery was significantly higher than baseline(at T1) in both groups.The MMSE scores at days 3 and 7 in group N were significantly higher than those in group C.The concentrations of serum NSE and S100β at T2 and T3 in group N were significantly lower than those in group C.CONCLUSIONS:Oral nicorandil,as a premedication before liver transplantation,improves postoperative MMSE scores.It also attenuates the increase of NSE and S100β in blood,indicating its cerebral protectivBACKGROUND:Neurological injury is a common complication in the early period after liver transplantation,posing an enormous obstacle to treatment efficiency and patient survival.Nicorandil is a mitochondrial ATP-sensitive potassium channel(mitoK ATP) opener.It has been reported to be effective in reducing brain injury in recent studies.However,it is still unclear whether nicorandil has cerebral protective effect in patients undergoing liver transplantation.METHODS:Fifty patients scheduled for liver transplantation were randomly divided into a nicorandil group(group N)(n=25),in which patients received 10 mg nicorandil through a nasogastric tube 30 minutes before induction of anesthesia,and a control group(group C)(n=25) who received 10 mL normal saline.The Mini-Mental State Examination(MMSE) was performed before anesthesia(day 0),and on days 3 and 7 after surgery.Blood samples were obtained before induction of anesthesia(T1),and at 12(T2) and 36 hours(T3) after surgery for determination of serum neuron-specific enolase(NSE) and S100β protein(S100β) concentrations.RESULTS:During surgery,5 patients in each group were eliminated due to severe reperfusion or renal insufficiency.Therefore,20 patients remained in each group.The MMSE scores after operation were significantly lower than those before operation in group C.However,there was no difference at days 3 and 7 compared with day 0 in group N.Serum NSE concentrations after surgery were significantly higher than baseline(at T1) in both groups,except at T3 in group N.Serum S100β concentration after surgery was significantly higher than baseline(at T1) in both groups.The MMSE scores at days 3 and 7 in group N were significantly higher than those in group C.The concentrations of serum NSE and S100β at T2 and T3 in group N were significantly lower than those in group C.CONCLUSIONS:Oral nicorandil,as a premedication before liver transplantation,improves postoperative MMSE scores.It also attenuates the increase of NSE and S100β in blood,indicating its cerebral protectiv

关 键 词：NICORANDIL PREMEDICATION liver transplantation cerebral protection 

分 类 号：R657.3[医药卫生—外科学]