Effects of tetramethylpyrazine on serum S100β protein, neuron specific enolase, superoxdie dismutase and malondialdehyde content and cerebral oxygen supply-consumption balance and energy metabolism in patients during supratentorial tumor resection

Abstract

Objective To evaluate the effects of intraoperative tetramethylpyrazine infusion on serum S100β protein (S100β),neuron-specific enolase (NSE),superoxdie dismutase (SOD) and malondialdehyde (MDA) content and cerebral oxygen supply-consumption balance and energy metabolism in patients during supratentorial tumor resection.Methods Twenty-four patients undergone supratentorial tumor resection,ASA Ⅰ-Ⅱ degree,age 18-65,were randomly divided into control group (Group A,n=12) and the TMP group (Group B,n=12).Group B received 0.9％ sodium chloride 250 ml contained tetramethylpyrazine 80 mg in 20 min when the dural open,while group A was given the same amount of 0.9％ sodium chloride.Blood samples were taken from artery and jugular venous bulb simultaneously before induction of anesthesia (T1),after intubation(T2),opening dura instantly (T3),1 h after opening dura (T4),at the closure of dura (T5),and 24 h after operation (T6),for analyzing the blood-gas and calculating the content of artery blood oxygen,saturation of internal jugular venous bulb blood oxygen,content of internal jugular venous bulb blood oxygen,content of artery-internal differences in oxygen and cerebral extraction ratio oxygen.Glucose extraction ratio,cerebral lactate acid extraction rate,lactate oxygen index.Concentration of internal jugular venous bulb serum S100β,NSE,SOD,MDA.The data of mean artery pressure,heart rate,hematocrit and hemoglobin were recorded at the same time intervals.Results ① Compared with T1 [ (36±5)％,(35±5)％] the cerebral extraction ratio oxygen in both groups were significant decrease at T2 [(24±6)％,(25±5)％],but increased at T6 [(42±5)％,(41±6)％ ](P＜0.05).There were no differences between group A and B at each time intervals.② Compared with T1 [ (6.0±1.0)vol％,(6.4±1.1)vol％ ],there were significant decrease at T2 [ (4.2±1.1)vol％,(4.5±1.0)vol％ ] for the internal jugular venous bulb blood oxygen in both groups,and also at T5 (5.3±0.8)vol％,T6 (5.4±0.8)vol％ (P＜0.05)in group,and there were no differences between group A and B at each time intervals (P＞0.05).③ Compared with T1 [(0.073±0.009)％,(0.067±0.010)％],there were significant decrease for cerebral lactate acid production rate at T2 [ (-0.033±0.008)％,(-0.026±0.007)％ ],T3 [ (-0.031 ±0.006)％,(-0.028±0.005)％ ],T4 [ (.0.025±±0.005)％,(.0.026±0.006)％ ],T5 [(-0.022±0.008)％,(-0.027±0.008)％ ] and T6 [ (0.021±0.005)％),(-0.024±0.003)％] in both groups(P＜0.05).④ Compared with T1 [(0.021 6±0.007 3),(0.022 5±0.007 0) ],-there were significant decrease for lactate oxygen index at T2 [(-0.021 3±0.009 1),(-0.014 1±0.004 1)],T3 [(-0.013 2±0.004 2),(-0.012 3±0.003 3) ],T4 [ (-0.011 4±0.002 9 ),(-0.012 4±0.004 3) ],T5 [ (-0.011 2±0.003 4 ),( 40.014 3±0.005 1 ) ] and T6 [ (-0.010 3±0.003 0 ),(-0.011 0±0.002 0)] in both groups(P＜0.05).⑤ S0D decreased at T3 (77±13),T4 (69±9),T5 (65±12) and T6 (75±14) U/ml compared with T1(99±9) U/ml(P＜0.05)in group A.SOD decreased at T3 (84±12),T4 (79±12),T5 (76±12) U/ml compared with T1 (98±10) U/ml in group B,but with a less decline than group A at the same time intervals (P＜0.05).⑥ There were no differences during each time interval in group A for MDA.While in group B,there were significant decrease at T4 [ (5.6±0.7)vs(6.9±1.3)],T5 [ (5.6±0.5)vs(6.7±1.5)] and T6 [(5.7±0.5)vs (6.5±0.9)] μ mol/L compared with group A at the same time interval (P＜0.05).⑦ S100β at T4 [(1.60±0.43 )vs( 1.81±0.10) ],T5 [ ( 1.60±0.57 )vs(1.86±0.08) ] and T6 [ ( 1.59±0.05 )vs( 1.89±0.07 ) ] μg/L,together with NSE at T4 [ ( 17.4±1.1 )vs(20.3±1.1 ) ]、T5 [ (16.7±1.2)vs(21.3±0.9) ]、T6 [ (15.9±1.2)vs(22.2±0.7) ] μg/L in group B were both decline compared with group A at the same time interval (P＜0.05).Conclusions Under the total intravenous anesthesia during supratentorial tumor surgery,tetramethylpyrazine can increase serum SOD activity and decrease MDA content and serum S100β,NSE concentration.But it did not affect the imbalance of patient's cerebral oxygen supply and demand,and the energy metabolism. Key words: Supratentorial tumor resection ; Tetramethylpyrazine/ligustrazine ; Brain protection ;