Effects of sevoflurane wash-in during cardiopulmonary bypass on myocardial injury in patients undergoing coronary artery bypass grafting
10.3760/cma.j.issn.0254-1416.2011.10.009
- VernacularTitle:体外循环旁路洗入七氟醚对冠状动脉旁路移植术患者心肌损伤的影响
- Author:
Yongwang WANG
;
Zhong WANG
;
Yuliang XUE
;
Kaiyuan WANG
;
Yali DONG
;
Qi WU
- Publication Type:Journal Article
- Keywords:
Anesthetics,inhalation;
Myocardial reperfusion injury;
Cardiopulmonary bypass;
Coronary artery bypass graft
- From:
Chinese Journal of Anesthesiology
2011;31(10):1196-1199
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of sevoflurane wash-in during cardiopulmonary bypass (CPB) on myocardial injury in patients undergoing coronary artery bypass grafting(CABG).Methods Forty ASA Ⅱ or Ⅲ patients aged 50-64 yr,weighing 53-90 kg undergoing scheduled for CABG under CPB were randomly divided into 2 groups (n =20): control group (group C) and sevoflurane group(group S).Anesthesia was maintained with propofol 3-5 mg·kg-1 ·h-1 and sufentanil 0.5-1.0 μg·kg-1 ·h-1 in both groups.Sevoflurane 1％-2％ was washed into extracorporeal circuit during CPB in group S.Blood samples were taken from central vein after the induction of anesthesia (T0,baseline) and at 6,12 and 24 h (T1-3) after operation for determination of plasma cardiac troponin I(cTnI) concentration and creatine kinase-MB (CK-MB) activity.Myocardial specimens were obtained from right auricle before aortic cross-clamping and at the end of CPB for ultrastructure examination.The severity of mitochondria injury was assessment and scored (0 =normal,4 =impaired inner mitochondrial membrane integrity).Results CPB significantly increased plasma cTnI concentration at T1-3 as compared with the baseline values at T0 before CPB.Plasma cTnI concentration was significantly lower at T2 and T3 in group S than in group C.Mitochondrial injury index was significantly lower at the end of CPB in group S than in group C.There was no significant difference in plasma CK-MB activity between the 2 groups.Conclusion Wash-in of sevoflurane during CPB can attenuate myocardial injury in patients undergoing CABG.
