Anesteziol Reanimatol. 2011 Nov-Dec(6):13-6.
The aim of the study is to investigate cardioprotective properties of sevoflurne during coronary bypass surgery with extracorporeal circulation.
60 patients with coronary heart disease (left ventricular ejection fraction 61,3+1,0%) underwent surgery with extracorporeal circulation. Inhalation anesthesia with Sevoflurane and TIVA were performed. Hemodynamic, troponin level, KFK, protein of heart shock in plasma (PHS 70) and PHS in myocard were monitored.
patients who were administrated with Sevoflurane had lower level of troponin than patients of second group. In postperfusion period the amount of PHS 70 in myocard increased in 1.6 times than in preperfusion period in comparison to TIVA method this figure did not change. There was negative correlation in level of PHS 70 in plasma and troponin in first day after the operation (r = -0,61 p < 0,05) and second day (r = - 0,76, p < 0,05). In conclusion Sevoflurane had affected hemodynamic less than TIVA. Increased level of PHS has cardioprotective effects.
本研究旨在探讨七氟醚在体外循环冠状动脉搭桥手术中的心脏保护特性。
60例冠心病患者(左心室射血分数61.3±1.0%)接受体外循环手术。采用七氟醚吸入麻醉和全凭静脉麻醉。监测血流动力学、肌钙蛋白水平、KFK、血浆中心脏休克蛋白(PHS 70)及心肌中的PHS。
使用七氟醚的患者肌钙蛋白水平低于第二组患者。与全凭静脉麻醉方法相比,在灌注后期,心肌中PHS 70的量比灌注前期增加了1.6倍,而全凭静脉麻醉组该数值未改变。术后第一天(r = -0.61,p < 0.05)和第二天(r = -0.76,p < 0.05),血浆中PHS 70水平与肌钙蛋白水平呈负相关。总之,七氟醚对血流动力学的影响小于全凭静脉麻醉。PHS水平升高具有心脏保护作用。