Effect of sevoflurane anesthesia on left ventricular synchronization in patients undergoing coronary artery bypass grafting
10.3760∕cma.j.issn.0254-1416.2016.09.022
- VernacularTitle:七氟醚麻醉对冠状动脉旁路移植术患者左心室内同步化的影响
- Author:
Jiaoqing WU
;
Hongwei SHI
;
Qiyue HE
;
Haiyan WEI
;
Yali GE
- Keywords:
Anesthetics,inhalation;
Coronary artery bypass;
Cardiac pacing,artificial;
Heart ventricles
- From:
Chinese Journal of Anesthesiology
2016;36(9):1126-1129
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of sevoflurane anesthesia on left ventricular synchroni?zation in patients undergoing coronary artery bypass grafting ( CABG ) . Methods Twenty?six patients of both sexes, aged 45-75 yr, with body mass index of 19-30 kg∕m2 and body surface area 1.4-2.0 m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ and New York Heart Association class ⅡorⅢ, undergoing elective CABG with cardiopulmonary bypass, were divided into 2 groups using a random number table: control group ( group C, n=11) and sevoflurane group ( group S, n=15) . After induction of general anesthesia, the patients were endotracheally intubated and mechanically ventilated. Anesthesia was maintained with iv infusion of propofol 4-6 mg·kg-1 ·h-1 , remifentanil 0. 2-0. 3 μg·kg-1 ·min-1 and cisatracurium 0.10-0.15 mg·kg-1·h-1, and intermittent iv boluses of fentanyl 0.5 μg∕kg, and bis?pectral index value was maintained at 40-60. In group S, sevoflurane ( end?tidal concentration: 2.05% for 45-49 yr, 1.80% for 50-59 yr, 1.60% for 60-75 yr) was inhaled for 30 min starting from 15 min after termination of cardiopulmonary bypass, followed by 30 min washout. The parameters of cardiac function
were monitored using transesophageal echocardiography. After induction and before sternotomy, immediate?ly before sevoflurane inhalation, at 30 min of sevoflurane inhalation, and at 30 min of washout, heart rate, mean arterial pressure, central venous pressure, pulmonary artery occlusion pressure, cardiac output, left ventricular ejection fraction, standardized standard deviation of time to peak systolic longitudinal strain of R?R interval ( Tssl?SD) of 17 left ventricular segment, and standardized standard deviation of time to peak systolic circumferential strain of R?R interval ( Tssc?SD) of 16 left ventricular segment were recorded. Re?sults Cardiac output and left ventricular ejection fraction were within in the normal ranges in the two groups. Compared with group C, heart rate was significantly decreased at 30 min of sevoflurane inhalation and 30 min of washout, and mean arterial pressure, cardiac output and left ventricular ejection fraction were significantly decreased at 30 min of sevoflurane inhalation in group S (P<0.05 or 0.01). There were no significant differences in standardized Tssl?SD and standardized Tssc?SD between group S and group C ( P>0.05) . Conclusion Sevoflurane anesthesia has no marked effect on the left ventricular synchronization in patients undergoing CABG.
