Huseidzinović Ino, Barisin Stjepan, Bradić Nikola, Milanović Rudolf
Clinical Department of Anesthesiology, Reanimatology, and Intensive Care, Dubrava University Hospital, Zagreb, Croatia.
Croat Med J. 2007 Jun;48(3):333-40.
To evaluate the cardioprotective effect of sevoflurane on a beating heart in patients undergoing coronary artery bypass grafting with normal preoperative left ventricular function.
The randomized controlled study included 32 patients induced with sevoflurane and then randomized to receive either 1 minimal alveolar concentration (MAC) end-tidal concentration of sevoflurane (n=16) or propofol (n=16) 2 to 3 mg kg(-1) hour(-1). The acceleration of the aortic blood flow, cardiac index, heart rate, mean arterial pressure, and central venous pressure were measured 5 minutes after anesthesia induction, at the beginning of ischemia, 15 minutes after ischemia, and 15 minutes after sternum closure.
There were no differences in heart rate, mean arterial pressure, and central venous pressure within each group and between groups during surgery. Acceleration increased in the sevoflurane group 15 minutes after ischemia (10.3+/-3.5 m/s(2); P=0.004) and 15 minutes after sternum closure (10.7+/-3.9 m/s(2); P<0.001). Acceleration in the propofol group decreased from the beginning of ischemia (P<0.001) and remained lower 15 minutes after sternum closure (P=0.001 and P=0.024, respectively). Acceleration was higher in the sevoflurane group at the beginning of ischemia and 15 minutes after sternum closure (P=0.017 and P=0.046, respectively). There were no significant differences in cardiac index values within the sevoflurane group. In the propofol group, significant decreases in cardiac index were seen at the beginning of ischemia (P<0.001). There were between-group differences in cardiac index values at the beginning of ischemia and 15 minutes after ischemia (P=0.002, and P=0.011, respectively).
Cardiac function was better preserved in the patients anesthetized with sevoflurane than in patients anesthetized with propofol.
评估七氟醚对术前左心室功能正常的冠状动脉搭桥手术患者跳动心脏的心脏保护作用。
这项随机对照研究纳入32例患者，先以七氟醚诱导麻醉，然后随机分为两组，一组接受1最低肺泡有效浓度（MAC）的七氟醚呼气末浓度（n = 16），另一组接受丙泊酚2至3毫克/千克/小时（n = 16）。在麻醉诱导后5分钟、缺血开始时、缺血15分钟后以及胸骨关闭后15分钟测量主动脉血流加速度、心脏指数、心率、平均动脉压和中心静脉压。
手术期间，每组内及两组间的心率、平均动脉压和中心静脉压均无差异。七氟醚组在缺血15分钟后（10.3±3.5米/秒²；P = 0.004）和胸骨关闭后15分钟（10.7±3.9米/秒²；P < 0.001）主动脉血流加速度增加。丙泊酚组的主动脉血流加速度从缺血开始时下降（P < 0.001），在胸骨关闭后15分钟仍较低（分别为P = 0.001和P = 0.024）。在缺血开始时和胸骨关闭后15分钟，七氟醚组的主动脉血流加速度较高（分别为P = 0.017和P = 0.046）。七氟醚组内心脏指数值无显著差异。在丙泊酚组，缺血开始时心脏指数显著下降（P < 0.001）。在缺血开始时和缺血15分钟后，两组间心脏指数值存在组间差异（分别为P = 0.002和P = 0.011）。
与丙泊酚麻醉的患者相比，七氟醚麻醉的患者心脏功能得到更好的保留。
