Combined anesthesia based on xenon and assessment of possibility of its application as method of neuroprotective influence at intra cranial operations

• V.M. Mizikov
• A.A. Vyatkin
• L.G. Petrosyan
• L.I. Vinnitsky
• L.O. Samokhina

Abstract

Aim: to develop a technique of anesthesia with xenon at intra cranial neurosurgical operations, to estimate its opportunities for neuro- and cerebral protection.

Methods. 72 patients to whom carried out a brain and skull bones operations are surveyed. Groups: 1st (n=12) – with xenon monoanesthesia; 2nd (n=20) – combination of xenon and isoflurane; 3rd (n=20) – a combination of xenon and sevoflurane, and control (n=20) – anesthesia based on sevoflurane.

Main results. In first group often noted arterial hypertension and carried out its medicated treatment, regis- tered superficial level of anesthesia. The consumption of phentanyl and cisatracurii besilas was higher, than in control group. After operation are revealed quick restoration of consciousness (10,2±2,03 min.) which in 50% of cases was accompanied by hyper dynamic re- action of blood circulatory system, the high frequency of postoperative vomiting (POV) (67%). In groups 2, 3 and 4 there was not distinctions of intraoperative hemodynamic. Dosages of phentanyl and muscle relaxant, a current of postoperative period in groups 3 and 4 didn’t differ. POV frequency in groups with xenon – 30–45%. NSE and S-100 increase in group 3 by the operation end (6,48±1,23 mkg/l and 101,88 ng/l), in 24 h – NSE return to initial level (6,25±2,05 mkg/l) and decrease in S-100 (88,2 ng/l) is revealed. Concentration of S-100 and NSE increased by the operation end, further lifting of the NSE level proceeded in 24 h in group 4.

Conclusions. Xenon monoanesthesia at intra cranial surgical interventions is inexpedient because of its insufficient hypnotic and analgesic activity. Combined isoflurane (or sevoflurane)/xenon anesthesia does not show bigger hemodynamic stability, than the combined anesthesia based on sevoflurane. Despite prevention, at xenon anesthesia the POV frequency remains significant. Studying of dynamics of neurospecific proteins in perioperative period didn’t reveal convincing data of xenon neuroprotective effect at intra cranial operations. Probably, it is connected with insufficient sample of patients.

Keywords:xenon, neuroprotection, neurospecific proteins, anesthesia in neurosurgery, S-100, NSE

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)