Relationship between anesthetic factor and intestinal injury in patients undergoing cardiac surgery with cardiopulmonary bypass: a comparison of propofol-versus sevoflurane-based anesthesia
10.3760/cma.j.issn.0254-1416.2016.12.009
- VernacularTitle:麻醉因素与体外循环心脏手术患者肠损伤的关系:异丙酚复合麻醉与七氟醚复合麻醉的比较
- Author:
Yiri DU
;
Rina SU
;
Jianshe YU
- Keywords:
Anesthesia,general;
Propofol;
Cardiopulmonary bypass;
Intestinal mucosa;
Wounds and injuries;
Sevoflurane
- From:
Chinese Journal of Anesthesiology
2016;36(12):1444-1447
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship between anesthetic factors and intestinal injury in the patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB).Methods Ninety American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes,aged 18-64 yr,with New York Heart Association grade Ⅱ or Ⅲ,undergoing elective cardiac surgery with CPB,were divided into 2 groups (n =45 each) using a random number table:propofol-based anesthesia group (group P) and sevoflurane-based anesthesia group (group S).CPB was established routinely after anesthesia induction.Before induction (T0),immediately after aortic unclamping (T1),at 30 min after aortic unclamping (T2) and at 2 h after discontinuation of CPB (T3),blood samples were collected from the radial artery for determination of the plasma endotoxin,D-lactic acid,diamine oxidase (DAO) and intestinal fatty acid-binding protein (Ⅰ-FABP) concentrations (by enzyme-linked immunosorbent assay) and plasma interleukin-6 (IL-6),IL-8 and tumor necrosis factor-alpha (TNF-o) concentrations (using radio-immunity method).Results Compared with the baseline at T0,the concentrations of plasma endotoxin,D-lactic acid,DAO,TNF-α,IL-6,IL-8 and I-FABP were significantly increased at T1-T3 in both groups (P＜0.05).Compared with group P,the concentrations of plasma endotoxin,D-lactic acid,DAO,TNF-α,IL-6,IL-8 and I-FABP were significantly decreased at T1-T3 in group S (P＜0.05).Conclusion Anesthetic factors are related to intestinal injury in patients undergoing cardiac surgery with CPB.Compared with propofol-based anesthesia,sevoflurane-based anesthesia is helpful in reducing the inflammatory response and in decreasing the degree of intestinal injury and is more suitable for the cardiac surgery with CPB.
