Effect of two administration routes of Shenmai Injection () on pulmonary gas exchange function after tourniquet-induced ischemia-reperfusion.
OBJECTIVE
To compare the effect between nebulized and intravenous administration of Shenmai Injection () on pulmonary gas exchange function of patients following tourniquet-induced lower limb ischemia-reperfusion.


METHODS
Thirty-eight patients scheduled for lower extremity surgery were randomized into three groups using the closed envelop method: Shenmai Injection was administered 30 min before tourniquet inflflation by nebulization [0.6 mL/kg in 10 mL normal saline (NS)] in the nebulization group or by intravenous drip (0.6 mL/kg dissolved in 250 mL of 10% glucose) in the intravenous drip group, and equal volume of NS was given intravenously in the NS group; 15 in each group. Arterial blood gases were analyzed, serum levels of malonaldehyde (MDA) and interleukine-6 (IL-6) and interleukine-8 (IL-8) were determined using the method of thiobarbituric acid reaction and enzyme-linked immuno sorbent assay respectively just before tourniquet inflflation (T0), and at 0.5 h (T1), 2 h (T2), 6 h (T3) after tourniquet deflflation.


RESULTS
Compared with baselines at T0, MDA levels signifificantly increased at T2, T3 in the NS group and at T3 in the nebulization group, and IL-6 and IL-8 levels were signifificantly increased at T2, T3 in NS, the intravenous drip and the nebulization groups (P <0.05). Arterial pressure of oxygen (PaO2) at T3 was decreased, while alveolararterial oxygen tension showed difference (PA-aDO2) at T3 in the NS group; RI at T3 in both intravenous drip and the nebulization groups were enhanced (P <0.05). Compared with the NS group, MDA and IL-8 levels at T2, T3, IL-6 at T3 in the intravenous drip group, and IL-8 at T3 in the nebulization group were all remarkably increased (P <0.05). Additionally, MDA level at T3 in the nebulization group was higher than that in the intravenous drip group (P <0.05).


CONCLUSIONS
Intravenous administration of Shenmai Injection provided a better protective effect than nebulization in mitigating pulmonary gas exchange dysfunction in patients following tourniquet-induced limb ischemia-reperfusion.
Department of Anesthesiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou Zhejiang, 325000, China.
Jian-Guo
JG
Jin
Department of Anesthesiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou Zhejiang, 325000, China.
Hai-Jian
HJ
Shen
Department of Anesthesiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou Zhejiang, 325000, China.
Yuan-Lu
YL
Shan
Department of Anesthesiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou Zhejiang, 325000, China.
Lei
L
Chen
Department of Anesthesiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou Zhejiang, 325000, China.
Xi-Yue
XY
Zhao
Department of Anesthesiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou Zhejiang, 325000, China.
Liang-Rong
LR
Wang
Department of Anesthesiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou Zhejiang, 325000, China. wzlinlina@163.com.
Li-Na
LN
Lin
D000328:Adult; D001784:Blood Gas Analysis; D004333:Drug Administration Routes; D004338:Drug Combinations; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007267:Injections; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D011659:Pulmonary Gas Exchange / Q000187:drug effects; D015427:Reperfusion Injury / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology*; D014111:Tourniquets / Q000009:adverse effects*
D004338:Drug Combinations; D004365:Drugs, Chinese Herbal; D015850:Interleukin-6; D016209:Interleukin-8; C009252:fructus schizandrae, radix ginseng, radix ophiopogonis drug combination; D008315:Malondialdehyde
Chinese medicine; Shenmai Injection; administration routes; pulmonary gas exchange; tourniquet