Comparison of Sevoflurane and Propofol on Cerebral Oxygen Metabolism and Postoperative Cognitive Function During Cardiopulmonary Bypass
10.3870/j.issn.1004-0781.2016.04.006
- VernacularTitle:七氟烷和丙泊酚麻醉对体外循环脑氧代谢及术后认知功能的比较
- Author:
Huaping YUAN
;
Yanjun LIU
;
Chun CHEN
;
Jun HOU
- Publication Type:Journal Article
- Keywords:
Sevoflurane;
Propofol;
Cardiopulmonary bypass;
Oxygen metabolism;
Cognitive impairment
- From:
Herald of Medicine
2016;35(4):349-352
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the effects of sevoflurane and propofol on cerebral oxygen metabolism and postoperative cognitive function during cardiopulmonary bypass (CPB). Methods Fifty ASA Ⅱ or Ⅲ patients aged 40-65 years old scheduled for cardiac valve replacement surgery with CPB were randomly assigned into two groups,sevoflurane group (group S) and propofol group (group P),25 in each group.Two groups of patients used the same method of anesthesia induction:midazolam 0.1 mg?kg-1,sufentanil 0.7 μg?kg-1,vecuronium 0.1 mg?kg-1,and etomidate 0.2 mg?kg-1 were intravenously injected successively,and then tracheal intubation was performed.For maintenance of anesthesia,patients of group S continuously inhaled 3%-4% sevoflurane, and patients of group P were intravenous pumped with propofol 4-6 mg?kg-1?h-1 via vein;midazolam,sufentanil and vecuronium bromide were intermittently injected in both groups.At the time points of pre-bypass (t1), nasopharynx temperature dropping to constant temperature regularly ( t2 ) ,nasopharynx temperature rising to constant temperature regularly ( t3 ) ,1 h after the end of CPB ( t4 ) ,and 6 h after the end of CPB ( t5 ) ,blood from radial artery and right jugular bulb was harvested for blood gas analysis,and mini-mental state examination( MMSE) score were evaluated before and 24 and 48 h after the surgery. Results The jugular venous bulb oxygen saturation( SjvO2 ) in the two groups were both increased during T2 period and then decreased during t3 period, but arteriovenous oxygen content difference ( AVDO2 ) and oxygen extraction rate (O2ER) were both decreased during t2 period and then increased during t3 period.There was no significant difference between the two groups during t2 and t3 period (P>0.05).MMSE scores of the two groups after operation were all less than those before operation,but that was significantly higher in the sevoflurane group than in the propofol group 24 h after the surgery ( t=4.34,P<0.05) . Conclusion The two anesthesia methods can meet the need of valve replacement surgery and maintain the cerebral oxygen balance during CPB period, but sevoflurane anesthesia has fewer influences in post-operation mental nerve functional changes.
