Mital Tanya, Hasija Suruchi, Das Sambhunath, Chauhan Sandeep, Khan Maroof A
Department of Cardiac Anaesthesia and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Department of Cardiac Anaesthesia and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Indian Heart J. 2025 Jul-Aug;77(4):275-280. doi: 10.1016/j.ihj.2025.05.007. Epub 2025 May 10.
Intravenous anaesthetics induce loss of consciousness in one arm-brain circulation time. As the circulatory transit time in patients with mitral stenosis (MS) and aortic stenosis (AS) is increased, the delivery of anaesthetics to the brain may be prolonged and consequently the onset of hypnosis. This study aimed to compare the induction time in patients with and without valvular heart disease (VHD).
Prospective, single-center, open-label analytical study.
It was conducted in adult patients undergoing elective cardiac surgery.
The patients (n = 144) were segregated into three groups; Group 1 - Stenotic VHD (MS, AS), Group 2 - Regurgitant VHD (Mitral Regurgitation, Aortic Regurgitation), and Group 3 - Control (coronary artery disease).
General anaesthesia was induced with intravenous thiopental 4mg kg bolus over 20s. The time to induction was noted as loss of eyelash reflex. Bispectral Index (BIS) values were recorded over 2 min. Statistical analysis was performed using SPSS software version 25.0. A p value < 0.05 was considered significant.
Patients in Group 1 (n = 48) had significantly prolonged induction time (99.6 ± 12.9s; p < 0.001) compared to the other two groups (n = 48 each) (68.5 ± 9.6s in Group 2 and 70.4 ± 11.8s in Group 3). Time required for BIS to fall below 60 was significantly longer in Group 1 (139.4 ± 24.6s; p < 0.001) compared to Group 2 (90.4 ± 6.3s) and Group 3 (92.1 ± 12s).
The induction time was prolonged in patients with stenotic VHD compared to patients with regurgitant VHD or those without VHD.
静脉麻醉药在一个臂-脑循环时间内诱导意识丧失。由于二尖瓣狭窄（MS）和主动脉瓣狭窄（AS）患者的循环转运时间延长，麻醉药向脑内的输送可能会延长，从而导致催眠起效时间延长。本研究旨在比较有和没有瓣膜性心脏病（VHD）患者的诱导时间。
前瞻性、单中心、开放标签分析研究。
在接受择期心脏手术的成年患者中进行。
患者（n = 144）被分为三组；第1组——狭窄性VHD（MS、AS），第2组——反流性VHD（二尖瓣反流、主动脉瓣反流），第3组——对照组（冠状动脉疾病）。
静脉注射硫喷妥钠4mg/kg，在20秒内推注，诱导全身麻醉。诱导时间记录为睫毛反射消失。在2分钟内记录脑电双频指数（BIS）值。使用SPSS 25.0软件进行统计分析。p值<0.05被认为具有统计学意义。
与其他两组（每组n = 48）相比，第1组（n = 48）患者的诱导时间显著延长（99.6±12.9秒；p<0.001）（第2组为68.5±9.6秒，第3组为70.4±11.8秒）。与第2组（90.4±6.3秒）和第3组（92.1±12秒）相比，第1组BIS降至60以下所需的时间显著更长（139.4±24.6秒；p<0.001）。
与反流性VHD患者或无VHD患者相比，狭窄性VHD患者的诱导时间延长。
