Xiong Hong-Yan, Liu Yang, Shu Duan-Chao, Zhang Sheng-Li, Qian Xinhong, Duan Wei-Xun, Cheng Liang, Yu Shi-Qiang, Jin Zhen-Xiao
From the *Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China; †Department of Thoracic & Cardiovascular Surgery, Xi'an Central Hospital, Xi'an, China; ‡Department of Cardiovascular Surgery, Baoji Municipal Central Hospital, Baoji, China; §Department of Cardiovascular Surgery, Shaanxi General Hospital of CAPF, Xi'an, China; and ¶Department of Pediatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
ASAIO J. 2016 Jan-Feb;62(1):63-8. doi: 10.1097/MAT.0000000000000285.
The effects of sevoflurane inhalation during cardiopulmonary bypass (CPB) on postoperative courses and serum cardiac troponin I (cTnI) concentrations in pediatric patients undergoing cardiac surgery have not been extensively investigated. In this single-center, prospective, randomized trial, an anesthetic regimen containing 2% sevoflurane used throughout the CPB process was compared with a total intravenous anesthesia (TIVA) regimen. One hundred and three patients undergoing congenital heart defect repair with CPB were included in this prospective randomized controlled study. They were randomized into two groups: the sevoflurane group, who received 2% sevoflurane during CPB via an oxygenator, and the control group, who received only an oxygen-air mixture. The pre- and intra-operative parameters were comparable between the two groups. There was a slight but significant increase of arterial diastolic pressure in the sevoflurane group immediately after CPB compared with control patients (46.9 ± 9.3 mm Hg vs. 43.6 ± 8.9 mm Hg; p = 0.033). There was no death in either group. The postoperative ventilation time (in mean [95% confidence interval]) was shorter in the sevoflurane group than that in the control group (26.1 [19.2, 33.0] h vs. 37.7 [24.4, 50.9] h; p = 0.014). The postoperative ICU time, hospital days, and serial serum cTnI concentrations were not significantly different between the two groups. Inhalation of 2% sevoflurane during CPB is beneficial to the recovery of pediatric patients undergoing cardiac surgery but has no significant effect on postoperative cTnI release.
体外循环（CPB）期间吸入七氟醚对接受心脏手术的儿科患者术后病程及血清心肌肌钙蛋白I（cTnI）浓度的影响尚未得到广泛研究。在这项单中心、前瞻性、随机试验中，将在整个CPB过程中使用含2%七氟醚的麻醉方案与全静脉麻醉（TIVA）方案进行了比较。103例接受CPB下先天性心脏缺陷修复术的患者纳入了这项前瞻性随机对照研究。他们被随机分为两组：七氟醚组，在CPB期间通过氧合器接受2%七氟醚；对照组，仅接受氧气-空气混合气体。两组的术前和术中参数具有可比性。与对照组患者相比，CPB后即刻七氟醚组的动脉舒张压略有但显著升高（46.9±9.3 mmHg对43.6±8.9 mmHg；p = 0.033）。两组均无死亡病例。七氟醚组的术后通气时间（平均[95%置信区间]）短于对照组（26.1[19.2, 33.0]小时对37.7[24.4, 50.9]小时；p = 0.014）。两组之间的术后ICU时间、住院天数及系列血清cTnI浓度无显著差异。CPB期间吸入2%七氟醚有利于接受心脏手术的儿科患者的恢复，但对术后cTnI释放无显著影响。
