Effect of Sevoflurane Pretreatment on Inflammatory Response and Lung Ventilation in Neonates Undergoing Thoracoscopic Correction of Type III Esophageal Atresia

Abstract

Neonatal thoracoscopic correction of type III esophageal atresia requires the establishment of an artificial carbon dioxide pneumothorax in the affected thoracic cavity. At present, there is no suitable doublelumen endotracheal tube or bronchial occluder to be used in neonatal thoracoscopic surgery. Objectives: To research the influence of sevoflurane pretreatment on neonatal inflammatory response and pulmonary ventilation. Sixty neonates were randomized into 2 groups, group C, group S. Neonates in group S received sevoflurane inhalation at a concentration of 2% after endotracheal intubation until the establishment of pneumothorax, followed by a 10-min washout period, while those in group C only inhaled pure oxygen. Venous blood samples were collected from the subjects in the 2 groups from at 10 min before induction of anesthesia to 24 h after pneumothorax relief to determine the concentrations of serum interleukin (IL)-6, IL-8, and tumor necrosis factor α. Arterial blood gases were drawn from the radial artery at the above time points. The alveolar-arterial oxygen partial pressure difference, and respiratory index were calculated. Concentrations of IL-6, IL-8, and tumor necrosis factor α in serum were all lower in group S. Alveolar-arterial oxygen and respiratory index were also lower in group S. Duration of surgical intensive care unit stay, time of mechanical ventilation, and length of stay were all lower in group S. A concentration of 2% sevoflurane HIGHLIGHTS• To research the influence of sevoflurane pretreatment on neonatal inflammatory response and pulmonary ventilation.• 60 neonates randomized into 2 groups, group C, group S.• A concentration of 2% sevoflurane pretreatment may exist a protective influence on neonatal inflammatory response.