Comparison of dexmedetomidine versus sevoflurane to reduce perioperative myocardial ischemia in coronary heart disease patients undergoing noncardiac surgery
- VernacularTitle:右美托咪定和七氟醚改善冠心病非心脏手术患者围术期心肌缺血的比较
- Author:
Jiru ZHANG
;
Min CHEN
;
Zhiqiang WANG
;
Nan DONG
;
Weifeng YU
- Keywords:
Dexmedetomidine;
Sevoflurane;
Coronary heart disease;
Noncardiac surgery
- From:
The Journal of Clinical Anesthesiology
2017;33(3):273-276
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of dexmedetomidine versus sevoflurane to perioperative myocardial ischemia in coronary heart disease patients undergoing noncardiac surgery.Methods A total of 135 patients (90 males,45 females,aged 45-82 years,ASA grade Ⅱ or Ⅲ) with coronary heart disease,undergoing endoscopic thoracic and abdominal surgery,were divided into control group (group C),dexmedetomidine group (group D) and sevoflurane group (group S) by random number table.Anesthesia induction and maintenance were adopted by etomidate 0.2 mg/kg,propofol 0.5 mg/kg,atracuronium sulfonate 0.2-0.3 mg/kg and fentanyl 5.0-6.0 μg/kg.Dexmedetomidine was given the continuous injection from 10 min before the start of the operation to the end in group D.Equal volume of saline was given in group C.Sevoflurane was inhaled from the induction of anesthesia 30 min before the end of surgery.ST segment changes of electrocardiogram were recorded for diagnosis of myocardial ischemia during the operation and postoperative 72 hours.Results The incidence of myocardial ischemia in group C,group D and group S were 26.7% (12 cases),6.7% (3 cases),8.9% (4 cases) during the operation and 13.3% (6 cases),8.9% (4 cases) and 8.9% (4 cases) postoperative 72 hours.Conclusion Dexmedetomidine and sevoflurane can improve the balance of blood oxygen supply and demand to reduce cardiovascular complications of non-cardiac surgery in patients with coronary heart disease.
