Effect of Two Administration Routes of Shenmai Injection （参麦注射液） on Pulmonary Gas Exchange Function after Tourniquet-Induced Ischemia-Reperfusiow

Objective： To compare the effect between nebulized and intravenous administration of Shenmai Injection （参麦注射液） on pulmonary gas exchange function of patients following tourniquet-induced lower limb ischemia-repeffusion. 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 inflation 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 inflation （TO）, and at 0.5 h （T1）, 2 h （TZ）, 6 h （T3） after tourniquet deflation. Results： Compared with baselines at TO, MDA levels significantly increased at TZ, T3 in the NS group and at T3 in the nebulization group, and IL-6 and IL-8 levels were significantly increased at TZ, T3 in NS, the intravenous drip and the nebulization groups （P〈0.05）. Arterial pressure of oxygen （PaO2） at T3 was decreased, while alveolar- arterial 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 TZ, T3, 11-6 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-repertusion.