De Hert S, Vlasselaers D, Barbé R, Ory J-P, Dekegel D, Donnadonni R, Demeere J-L, Mulier J, Wouters P
Division of Cardiothoracic and Vascular Anaesthesiology, Academic Medical Center, Amsterdam, Netherlands.
Anaesthesia. 2009 Sep;64(9):953-60. doi: 10.1111/j.1365-2044.2009.06008.x.
A randomised study of 414 patients undergoing coronary artery surgery with cardiopulmonary bypass was conducted to compare the effects of a volatile anaesthetic regimen with either deesflurane or sevoflurane, and a total intravenous anaesthesia (TIVA) regimen on postoperative troponin T release. The primary outcome variable was postoperative troponin T release, secondary outcome variables were hospital length of stay and 1-year mortality. Maximal postoperative troponin T values did not differ between groups (TIVA: 0.30 [0.00-4.79] ng x ml(-1) (median [range]), sevoflurane: 0.33 [0.02-3.68] ng x ml(-1), and desflurane: 0.39 [0.08-3.74] ng x ml(-1)). The independent predictors of hospital length of stay were the EuroSCORE (p < 0.001), female gender (p = 0.042) and the group assignment (p < 0.001). The one-year mortality was 12.3% in the TIVA group, 3.3% in the sevoflurane group, and 6.7% in the desflurane group. The EuroSCORE (p = 0.003) was the only significant independent predictor of 1-year mortality.
一项针对414例行体外循环冠状动脉手术患者的随机研究开展，以比较使用地氟烷或七氟烷的挥发性麻醉方案与全静脉麻醉（TIVA）方案对术后肌钙蛋白T释放的影响。主要结局变量为术后肌钙蛋白T释放，次要结局变量为住院时间和1年死亡率。术后肌钙蛋白T的最大值在各组间无差异（TIVA组：0.30 [0.00 - 4.79] ng x ml⁻¹（中位数[范围]），七氟烷组：0.33 [0.02 - 3.68] ng x ml⁻¹，地氟烷组：0.39 [0.08 - 3.74] ng x ml⁻¹）。住院时间的独立预测因素为欧洲心脏手术风险评估系统（EuroSCORE）（p < 0.001）、女性性别（p = 0.042）和分组（p < 0.001）。TIVA组的1年死亡率为12.3%，七氟烷组为3.3%，地氟烷组为6.7%。欧洲心脏手术风险评估系统（p = 0.003）是1年死亡率唯一显著的独立预测因素。
