Abstract：Objective To compare the effects of sevoflurane inhalation anesthesia and propofol based total intravenous anesthesia (TIVA) on the shedding of endothelial cell glycocalyx protein syndecan-1, hyaluronic acid and heparan sulfate in patients undergoing open lumbar fusion surgery. Methods A total of 100 patients scheduled for open lumbar fusion surgery in The Sixth Medical Center of Chinese PLA General Hospital were enrolled and randomly divided into inhalation anesthesia group (n=50) and TIVA group (n=50) , and anesthesia was maintained with sevoflurane/remifentanil or propofol/remifentanil, respectively. Serum endothelial injury markers syndecan-1, hyaluronic acid and heparan sulfate, and inflammatory mediators including C-reactive protein (CRP), TNF-α and IL-6 were measured before anesthesia, at the end of operation, and on the first day after operation (POD1). Results Compared with the inhalation anesthesia group [(17.45±1.65)ng/ml,(203.23±12.93)ng/ml,(3751.12±223.22)pg/ml], serum syndecan-1 [(14.96±2.79)ng/ml], hyaluronic acid [(195.94±8.64)ng/ml], and heparan sulfate levels [(3429.58±310.52)pg/ml] were significantly lower at the end of the surgery in the total intravenous anesthesia group (P<0.05), but there was no significant difference between the two groups on POD1 (P>0.05). There was no statistical difference in CRP, TNF-α or IL-6 between the two groups at any time points observed (P>0.05). Conclusions TIVA may be superior to inhalation anesthesia in terms of intraoperative protection of the endothelial glycocalyx, however, neither of the two anesthesia methods can prevent the shedding of endothelial cells syndecan-1, hyaluronic acid and heparan sulfate in patients undergoing open lumbar fusion surgery.
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2023, Vol. 34 
