摘要
Abstract
Objective To explore the effects of different concentrations of sevoflurane and propofol on myocardial protection and brain metabolism in patients undergoing cardiopulmonary bypass cardiac surgery.Methods A total of 74 patients who received cardiopulmonary bypass surgery in Jiamusi Central Hospital from June 2021 to December 2022 were selected as the study objects.They were divided into group B(37 cases)and group A(37 cases)by odd-even method.The anesthesia program of group A was 0.5 MAC sevoflurane + propofol plasma target control,and the anesthesia program of group B was 1.0 MAC sevoflurane + propofol plasma target control.The hemodynamic indexes,myocardial indexes,inflammatory factors and brain metabolism of the two groups were compared.Results There was no significant difference in mean arterial pressure(MAP),heart rate(HR),myocardial troponin Ⅰ(cTnI),creatine kinase(CK),creatine kinase isoenzyme(CK-MB),inflammatory factor levels,brain oxygen uptake rate(CEO2)and jugular glomus blood oxygen saturation(SjvO2)between the two groups before surgery(T0)(P＞0.05);After anesthesia induction(T1)and dermectomy(T2),the levels of MAP and HR in both groups showed A downward trend,and the indexes above the time after surgery(T3)showed an upward trend,and the levels of MAP and HR at T1,T2 and T3 in group B were lower than those in group A(P＜0.05).At T1,T2 and T3,the levels of cTnI,CK and CK-MB in two groups had an increasing trend and the levels of cTnI,CK and CK-MB in group B were lower than those in group A(P＜0.05).At T1,T2 and T3,The levels of interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)in group B were lower than those in group A(P＜0.05),and the levels of interleukin-10(IL-10)were higher than those in group A(P＜0.05).At T1,T2 and T3 SjvO2 level in group B was higher than that in group A(P＜0.05),and CEO2 level was lower than that in group A(P＜0.05).Conclusion The application of 1.0 MAC sevoflurane+propofol in extracorporeal circulation anesthesia for cardiac surgery has a significant effect,making patient hemodynamics more stable.At the same time,it can also reduce the impact on myocardial and brain metabolic indicators,effectively inhibit early inflammatory reactions.关键词
不同浓度/七氟烷/丙泊酚/体外循环心脏手术/心肌保护/脑代谢Key words
Different concentrations/Heptafluoroalkane/Propofol/Extracorporeal circulation cardiac surgery/Myocardial protection/Cerebral metabolism分类
医药卫生
