Effects of Shenfu injection on hemodynamics and plasma E-selectin concentration in elderly patients undergoing total hip replacement surgery

Abstract

To investigate the effects of Shenfu (SF) injection on hemodynamics and plasma E-selectin concentrations in elderly patients undergoing total hip replacement (THR). A total of 24 ASA II/III patients aged 65 to 85 years old were divided equally into two groups (n = 12). In Group S, SF injection was administered by peripheral intravenous infusion at initially 0.2 ml/kg and then 0.8 ml×kg(-1)×h(-1) until the end of operations. In Group N, normal saline was administered similarly. All patients received a post-operative regimen of patient-controlled epidural analgesia (PCEA). Blood samples were taken pre-operation (T(0)), immediately post-operation (T(3)) and 24 hours post-operation (T(4)) so as to detect the levels of E-selectin at these time points. mean arterial pressure (MAP), heart rate (HR) and central venous pressure (CVP) were continuously monitored and recorded at T(0), 15 min post-anesthesia (T(1)), 30 min post-anesthesia (T(2)) and T(3). The concentrations of E-selectin in Group N increased at T(3) and T(4) while those decreased in Group S [(119 ± 23) mg/L and (109 ± 23) mg/L vs (86 ± 15) mg/L, (83 ± 15) mg/L and (83 ± 12) mg/L vs (92 ± 37) mg/ L, all P < 0.01]. As compared with Group S, they were significantly higher in Group N (P < 0.05 or 0.01). There was no significant difference in CVP, HR and MAP between two groups. The activation of vascular endothelial cells is manifested by an elevated plasma concentration of E-selectin in the elderly patients undergoing THR. SF injection can inhibit the activation and exert no significant effects on the hemodynamics.