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丙泊酚与七氟醚在小儿活体肝移植中心肌保护作用的比较。

Comparison of Cardioprotective Effects of Propofol versus Sevoflurane in Pediatric Living Donor Liver Transplantation.

机构信息

Department of Anesthesiology, Tianjin First Center Hospital, Tianjin, China (mainland).

出版信息

Ann Transplant. 2020 May 12;25:e923398. doi: 10.12659/AOT.923398.

Abstract

BACKGROUND Our study compared the myocardiac protective effect of propofol vs. sevoflurane in pediatric patients receiving living donor liver transplantation (LDLT) surgery. MATERIAL AND METHODS We randomly and equally divided 120 children who underwent LDLT into a sevoflurane group and a propofol group. Preoperative, intraoperative, and postoperative data were collected and compared between the 2 groups. The concentrations of cTnI, CK-MB, IL-6, TNF-alpha, and HMGB1 at 5 min after induction (T0), 30 min in the anhepatic period (T1), and 3 h after reperfusion (T2), and at the end of surgery (T3) were measured. RESULTS There was no statistically significant difference in the characteristics of children in the 2 groups. Compared with T0, the levels of IL-6 and TNF-alpha at T1, T2, and T3 were higher, while the HMGB1 at T2 and T3 were higher (P<0.05). A similar trend for IL-6, TNF-alpha, and HMGB1 at different time points in the 2 groups was observed. Compared with T0, the cTnI and CK-MB at T2 and T3 were significantly higher (P<0.05), but there was no significant difference at different time points in the 2 groups. For the adverse events, there was no significant difference between the 2 groups. CONCLUSIONS Our study shows that the cardioprotective effect in pediatric patients undergoing living donor liver transplantation is similar with propofol and sevoflurane anesthesia.

摘要

背景

本研究比较了丙泊酚与七氟醚在接受活体肝移植(LDLT)手术的儿科患者中的心肌保护作用。

材料和方法

我们随机将 120 名接受 LDLT 的儿童平均分为七氟醚组和丙泊酚组。收集并比较两组患者的围手术期数据。测量诱导后 5 分钟(T0)、无肝期 30 分钟(T1)、再灌注后 3 小时(T2)和手术结束时(T3)的 cTnI、CK-MB、IL-6、TNF-α和 HMGB1 浓度。

结果

两组患儿的一般特征无统计学差异。与 T0 相比,T1、T2 和 T3 时 IL-6 和 TNF-α水平升高,T2 和 T3 时 HMGB1 水平升高(P<0.05)。两组在不同时间点的 IL-6、TNF-α和 HMGB1 均呈现出类似的趋势。与 T0 相比,T2 和 T3 时 cTnI 和 CK-MB 显著升高(P<0.05),但两组在不同时间点无显著差异。两组不良事件发生率无显著差异。

结论

本研究表明,丙泊酚和七氟醚麻醉对接受活体肝移植的儿科患者的心肌保护作用相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73eb/7243728/6d9d7c4e4b89/anntransplant-25-e923398-g001.jpg

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