Effects of edaravone combined with flurbiprofen axetil on tumor necrosis factor-α and interleukin-6 of patients under one-lung ventilation

Abstract

Objective To observe the effects of edaravone combined with flurbiprofen axetil on the levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in patients under one-lung ventilation (OLV). Methods A total of sixty patients undergoing thoracic surgery or radical resection for esophageal cancer were enrolled in this study. They were randomly divided into four groups (n=15): an edaravone group (group E), a flurbiprofen axetil group (group F), an edaravone combined with flurbiprofen axetil group (group E+F) and a normal saline group (group C). Patients underwent routine general anesthesia induction and maintenance. Then, 10 min after insertion of a double lumen endobronchial tube, group E was treated with 0.8 mg/kg edavarone, group F was treated with 1 mg/kg flurbiprofen axetil, group E+F was treated with 0.8 mg/kg edavarone and 1 mg/kg flurbiprofen axetil, and group C received 100 ml normal saline alone. Perioperavtive hemodynamics and blood gas indicators were recorded. The broncho-alveolar lavage fluid (BALF) of the ventilated lung and radial arterial blood samples (5 ml) were collected at two time points: after intubation (T1) and 60 min after OLV (T2). The concentrations of TNF-α in BALF and serum IL-6 were determined by ELISA. Results The partial pressure of oxygen in arterial blood (PaO2) was significantly decreased at T2 in all groups, compare with those at T1 (P<0.05). The TNF-α concentration in BALF was significantly decreased in groups E and E+F (P<0.05), but remarkably increased in group C at T2, compare with those at T1 (P<0.05). Compared with group C, groups E, F and E+F showed remarkably decreased levels of TNF-α at T2 (P<0.05). The concentration of IL-6 in group C at T2 were higher than that at T1 (P<0.05). Compared with group C, groups E, F and E+F showed remarkably decreased levels of IL-6 at T2 (P<0.05). Conclusions OLV can induce lung and systemic inflammatory response. Edaravone and flurbiprofen axetil can decrease the levels of TNF-α in BALF and serum IL-6 to inhibit inflammatory response in patients undergoing surgery with OLV, where no apparent advantage was found in combined use. Key words: Edaravone; Flurbiprofen axetil; One-lung ventilation; Tumor necrosis factor-α; Interleukin-6