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非体外循环冠状动脉搭桥手术中的心肌保护:七氟烷或地氟烷吸入麻醉与全静脉麻醉的比较

Myocardial protection during off pump coronary artery bypass surgery: a comparison of inhalational anesthesia with sevoflurane or desflurane and total intravenous anesthesia.

作者信息

Suryaprakash Sharadaprasad, Chakravarthy Murali, Muniraju Geetha, Pandey Saurabh, Mitra Sona, Shivalingappa Benak, Chittiappa Stany, Krishnamoorthy Jayaprakash

机构信息

Department of Anesthesiology, Fortis Hospital, Bannerghatta Road, Bangalore, Karnataka 560 052, India.

出版信息

Ann Card Anaesth. 2013 Jan-Mar;16(1):4-8. doi: 10.4103/0971-9784.105361.

Abstract

AIMS AND OBJECTIVES

The objective of the study was to evaluate the myocardial protective effect of volatile agents-sevoflurane and desflurane versus total intravenous anesthesia (TIVA) with propofol in offpump coronary artery bypass surgery (OPCAB) by measuring cardiac troponin-T (cTnT) as a marker of myocardial cell death.

MATERIALS AND METHODS

The study was conducted on 139 patients scheduled to undergo elective OPCAB surgery. The patients were randomly allocated to receive anesthesia with sevoflurane, desflurane or TIVA with propofol. The cTnT levels were measured preoperatively, at arrival in postoperative intensive care unit, at 8, 24, 48 and 96 hours thereafter.

RESULTS

The changes in cTnT levels at all time intervals were comparable in the three groups.

CONCLUSION

The study did not reveal any difference in myocardial protection after OPCAB with either sevoflurane or desflurane or TIVA using propofol as assessed by measuring serial cTnT values.

摘要

目的

本研究的目的是通过测量心肌肌钙蛋白T(cTnT)作为心肌细胞死亡的标志物,评估挥发性麻醉剂七氟醚和地氟醚与丙泊酚全静脉麻醉(TIVA)在非体外循环冠状动脉搭桥手术(OPCAB)中的心肌保护作用。

材料与方法

本研究对139例计划接受择期OPCAB手术的患者进行。患者被随机分配接受七氟醚、地氟醚麻醉或丙泊酚TIVA。术前、术后重症监护病房入院时、此后8小时、24小时、48小时和96小时测量cTnT水平。

结果

三组在所有时间间隔的cTnT水平变化相当。

结论

通过测量连续的cTnT值评估,本研究未发现七氟醚、地氟醚或丙泊酚TIVA在OPCAB术后的心肌保护方面存在任何差异。

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