Protective effect of sevoflurane on lung function of elderly chronic obstructive pulmonary disease patients undergoing total hip arthroplasty  

作　　者：Yuan Yao Man-Si Zhang Yue-Bing Li Ming-Zhe Zhang 

机构地区：[1]Department of Anesthesiology,The Second Hospital of Jiaxing,Jiaxing 314000,Zhejiang Province,China [2]Department of Pharmacy,Shangrao Municipal Hospital,Shangrao 334000,Jiangxi Province,China [3]Department of Anesthesiology,The Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310005,Zhejiang Province,China [4]Department of Anesthesiology,Dingzhou People’s Hospital,Dingzhou 073000,Hebei Province,China

出　　处：《World Journal of Clinical Cases》2023年第31期7619-7628,共10页世界临床病例杂志

基　　金：This study was registered in February 2018.Registration identification number is ChiCTR1900021234.

摘　　要：BACKGROUND Chronic obstructive pulmonary disease(COPD)is a common respiratory disorder that affects the elderly population and increases the risk of postoperative pulmonary complications(PPCs)after major surgeries.Sevoflurane is a volatile anesthetic that has been shown to have anti-inflammatory and antioxidant properties and attenuate lung injury in animal models.AIM To evaluate the protective effect of sevoflurane on the lung function of elderly COPD patients undergoing total hip arthroplasty(THA).METHODS In this randomized controlled trial,we randomly assigned 120 elderly patients with COPD,who were scheduled for THA,to receive either sevoflurane(sevoflurane group)or propofol(propofol group)as the maintenance anesthetic.The primary outcome was the incidence of PPCs within seven days after surgery.The secondary outcomes were changes in the lung function parameters,inflammatory markers,oxidative stress markers,and postoperative pain scores.RESULTS The results showed that the incidence of PPCs was significantly lower in the sevoflurane group than in the propofol group(10%vs 25%,P=0.02).Furthermore,the decline in the forced expiratory volume in 1 s,forced vital capacity,and peak expiratory flow was significantly lesser in the sevoflurane group than in the propofol group at 24 h and 48 h after surgery(P<0.05).The interleukin-6,tumor necrosis factor-alpha,malondialdehyde,and 8-hydroxy-2α-deoxyguanosine levels were significantly lower in the sevoflurane group than in the propofol group at 24 h after surgery(P<0.05).The sevoflurane group showed significantly lower postoperative pain scores than the propofol group at 6 h,12 h,and 24 h after surgery(P<0.05).CONCLUSION Sevoflurane protects the lung function of elderly COPD patients undergoing THA under general anesthesia by reducing the incidence of PPCs,attenuating inflammatory and oxidative stress responses,and alleviating postoperative pain.

关 键 词：SEVOFLURANE PROPOFOL Lung function Chronic obstructive pulmonary disease Total hip arthroplasty Elderly patients Inflammatory markers 

分 类 号：R473.5[医药卫生—护理学]