Role of Propofol Postconditioning on Oxidative Stress and Cognitive Function

Study Overview
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Brief Summary
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The purpose of this study was to evaluate differences between propofol postconditioning and sevoflurane anesthesia in the intracranial aneurysm surgery about antioxidant effect.

Detailed Description
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intracranial aneurysm surgery may lead to regional ischemic reperfusion injury. Propofol, as an antioxidative phenol, has been demonstrated that mitigate the brain I/R in rats. As for sevoflurane, some investigation indicated that sevoflurane is able to reduce oxidative stress in cell(except neuronal cell lines ) and rodent models, but the antioxidant effect did not found in human minor incision surgeries, furthermore, oxidative stress was raised in the major surgeries including orthopedic surgeries, hysterectomy, cholecystectomy, and thoracotomy

Official Title
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Role of Propofol Postconditioning on Oxidative Stress and Cognitive Function in Patients Undergoing Intracranial Aneurysm Surgery.

Conditions
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Cerebral Arterial Aneurysm

Intervention / Treatment
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* Drug: propofol postconditioning
* Drug: sevoflurane


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Clinical diagnosis intracranial aneurysm surgery , American Society of Anesthesiologists (ASA)Ⅰ-Ⅱ. Exclusion Criteria: severe hepatic and renal dysfunction coagulation disorder taking antioxidant perioperative period
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: propofol postconditioning<br>1.2mg/L propofol | Drug: propofol postconditioning<br>* administrated Target Controlled Infusion(TCI) of propofol (Cp 1.2ug/ml) and decreased sevoflurane with a Bispectral index (BIS) value of 40-60 to maintain anesthesia after clamp removal<br>Drug: sevoflurane<br>* 0.5%-2% sevoflurane with BIS 40-60<br>|
| Experimental: sevoflurane<br>0.5%-2% sevoflurane | Drug: sevoflurane<br>* 0.5%-2% sevoflurane with BIS 40-60<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evidences of Clinically Definite Oxidative Stress Confirmed by ELISA Kit | Evidences of clinically definite oxidative stress :Superoxide dismutase activity, Hydroxyl radical | before induction,after clamping removal ,operation ending ,1,3,7days post surgery | 
| Evidences of Clinically Definite Oxidative Stress Confirmed by ELISA | Evidences of clinically definite oxidative stress:8-isoprostane,as a reliable biomarkers of lipid peroxidation | before induction, after clamping removal,operation ending,1,3,7days post surgery | 
| Evidences of Clinically Definite Oxidative Stress:Micronuclei | Evidences of clinically definite oxidative stress:micronuclei confirmed by Cytokinesis-block Micronucleus Test | before induction,clamping removal ,operation ending,1,3,7days post surgery | 
| Evidences of Clinically Definite Oxidative Stress Confirmed by High Performance Liquid Chromatography | Evidences of clinically definite oxidative stress :α- tocopherol,γ- tocopherol which was used to assess the antioxidant defense. | before induction,after clamping removal ,operation ending ,1,3,7days post surgery | 
| Evidences of Clinically Definite Oxidative Stress: Nuclear Buds | Evidences of clinically definite oxidative stress:nuclear buds Confirmed by Cytokinesis-block Micronucleus Test | before induction,clamping removal ,operation ending,1,3,7days post surgery | 
| Evidences of Clinically Definite Oxidative Stress: Nucleoplasmic Bridges | Evidences of clinically definite oxidative stress: nucleoplasmic bridges confirmed by Cytokinesis-block Micronucleus Test | before induction,clamping removal ,operation ending,1,3,7days post surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mini Mental State Examination (MMSE) | A questionnaires is used to assess the cognitive function of patients in clinical,the total range was 0-30,and 27-30 were considered as normal value,<27 were considered as recognitive dysfunction. | before induction,1,3,7days post surgery | 
| Montreal Cognitive Assessment (MoCA) | A questionnaires is used to assess the cognitive function of patients in clinical,the total range was 0-30,and 27-30 were considered as normal value,<27 were considered as recognitive dysfunction. | before induction,1,3,7days post surgery |