Effects of sevoflurane pretreatment on the nuclear factor kappa B-DNA binding activity of leukocyte in peripheral blood of the patients undergoing cardiac valve replacement with cardiopulmonary bypass

Aim To investigate the effect of sevoflurane pretreatment on the nuclear factor kappa B(NF-κB)-DNA binding activity of leukocyte in peripheral blood of the patients undergoing cardiac valve replacement under cardiopulmonary bypass(CPB).Methods Twenty patients undergoing cardiac valve replacement under CPB were divided randomly into two groups:control group(group C)and sevoflurane pretreatment group(group S).All patients were induced with midazolam 0.08~0.12 mg·kg-1,fentanyl 5~10 μg·kg-1 and vecuronium 0.1 mg·kg-1.After endotracheal intubation,mechanical ventilation was conducted with 100% oxygen.Anesthesia in group C was maintained with intermittent intravenous fentanyl and midazolam,while in group S maintained with 2MAC sevoflurane besides fentanyl and midazolam intermittently before CPB.The anesthesia depth was kept to maintain the systolic pressure within 90~120 mmHg in both groups.Sevoflurane was discontinued at the initiation of CPB,and the following anesthetic regimen was the same as that in group C.To examine the NF-κB-DNA binding activity,the arterial blood samples were withdrawn at the following time point:after endotracheal intubation and before inhaling sevoflurane(T0),30 min(T1),1 h(T2),2 h(T3),6 h(T4)after aortic de-clamping.Electrophoretic mobility shift assay(EMSA)was used to measure the NF-κB-DNA binding activity of leukocyte.The dosage of fentanyl,midazolam,dopamine,sodium nitroprusside and the rate of spontaneous heart resuscitation in both groups were recorded.Results The NF-κB-DNA binding activity in group C was increased significantly after aortic de-clamping,and it reached to maximum at T1,but it was not changed significantly in group S from T0 to T4.The value of EMSA at all time points was lower in group S except T0 than that in group C(P0.01).The rate of spontaneous heart resuscitation was significantly higher in group S than that in group C(P0.01);the total amount of fentanyl was 40~60 μg·kg-1 in group C,and 20~30 μg·kg-1 in group S and less dopamine was used in group S(P0.01),while sodium nitroprusside used did not show significant difference in both groups,and the total amount of dopamine used of each patient in both groups was positively correlated with the maximum value of EMSA(r=0.994,P0.01).Conclusion Sevoflurane pretreatment can attenuate the NF-κB-DNA binding activity of leukocyte in peripheral blood of the patients undergoing cardiac valve replacement under cardiopulmonary bypass.