Comparison of the myocardial protective effect of sevoflurane versus propofol in patients undergoing heart valve replacement surgery with cardiopulmonary bypass

BMC Anesthesiology

Research Article

Xiao-Lin Yang¹  Dan Wang¹  Guo-Yuan Zhang²  Xiao-Lan Guo² 

[1]Departments of Anaesthesiology, Affiliated Hospital of North Sichuan Medical College, 63# Wenhua Road, Shunqing District, 637000, Nanchong, Sichuan, People’s Republic of China

[2]Laboratory Medicine, Affiliated Hospital of North Sichuan Medical College, 637000, Nanchong, Sichuan, People’s Republic of China

关键词: Myocardial protection;    Cardiopulmonary bypass;    Heart valve replacement;    Sevoflurane;    Propofol;   

DOI  :  10.1186/s12871-017-0326-2

 received in 2016-08-30, accepted in 2017-02-20,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThis study aimed to compare myocardial protective effects of anaesthesia with intravenous infusion of propofol versus inhalation of sevoflurane in patients undergoing heart valve replacement surgery with cardiopulmonary bypass.MethodsSeventy-six patients undergoing valve replacement with cardiopulmonary bypass were randomly assigned to propofol or sevoflurane anesthesia during the surgery, respectively. For assessing myocardial injury, cardiac troponin I (cTnI) and creatine kinase isozyme (CK-MB) were determined before induction (T0), 0.5 h (T1) and 3 h (T2) after aortic unclamping, and 24 h (T3) and 48 h (T4) after surgery. The concentrations of interleukin (IL)-6 and IL-10 as the systemic inflammatory and anti-inflammatory markers were also measured at above time points.ResultsIn the sevoflurane group, the plasma concentrations of cTnI and CK-MB from Tl to T4 and the levels of IL-6 and IL-10 from T1 to T2 were lower than those in the propofol group. Moreover, a higher ratio of automatic heart beat recovery and a shorter length of intensive care unit or hospital stay were found in the sevoflurane group comparing with the propofol group.ConclusionSevoflurane anaesthesia produced more prominent myocardial protection and attenuated inflammatory response than propofol anaesthesia in patients with valve replacement surgery under cardiopulmonary bypass, resulting in shorter ICU and in-hospital stay.Retrospective clinical trial registrationIdentified as ChiCTR-IOR-16009979 at http://www.chictr.org.cn/.

【 授权许可】

CC BY   
© The Author(s). 2017