[Effects of intraoperative application of radical scavenger edaravone in severe elderly cases]

To observe the effects of intraoperative application of radical scavenger edaravone in severe elderly cases.

A total of 400 severe elderly patients scheduled for surgery were randomly assigned to receive edaravone 60 mg/40 ml (Group Y) or an equal volume of normal saline (Group C). The arterial blood samples were harvested at immediately after pricking, 1 hour after the beginning of surgery and before saturation to determine the levels of superoxide dismutase (SOD) and malondialdehyde (MDA). The operative duration, fluid volume, blood loss, blood transfusion volume, urine output, intraoperative adverse events, mortality rate, total hospital stay, intensive care unit (ICU) stay, postoperative mechanical ventilation time and complications were recorded. Patients undergoing off-pump coronary artery bypass graft (OPCABG) were evaluated for troponin I (cTnI) and left ventricular ejection fraction (LVEF) before and after 24 hours of surgery.

SOD was higher and MDA lower in Group Y than those in Group C at 1 hour intraoperation and before saturation [SOD: (87 ± 14) U/ml vs (78 ± 14) U/ml, (83 ± 13) U/ml vs (77 ± 14) U/ml, P < 0.01, < 0.05; MDA: (11 ± 5) nmol/L vs (14 ± 7) nmol/L, (11 ± 5) nmol/L vs (14 ± 6) nmol/L, P < 0.05, < 0.01]. There were more intraoperative hypotension cases requiring a continuous application of vasoactive drugs in Group C (37 cases vs 19 cases), total hospital stay [(21 ± 9) d vs (23 ± 9) d, P < 0.05] and ICU stay [(10 ± 7) d vs (13 ± 9) d, P < 0.05] were also longer. Postoperative cTnI and LVEF of Group Y significantly improved in OPCABG cases (all P < 0.05).

The intraoperative application of edaravone in severe elderly patients may prevent MDA increase and SOD decrease and reduce free radical damage. Especially in OPCABG patients, cTnIand LVEF improve significantly.