Effect of midazolam and propofol on cytokine balance in patients undergoing cardiac valve replacement
- VernacularTitle:咪唑安定和异丙酚对体外循环心瓣膜置换术患者细胞因子平衡的影响
- Author:
Zhiying FENG
;
Jun CHEN
;
Qinglian CHEN
- Publication Type:Journal Article
- Keywords:
Midazolam;
Propofol;
Cardiopulmonary bypass;
Cytokines
- From:
Chinese Journal of Anesthesiology
1994;0(01):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effect of midazolam and propofol on cytokine balance in patients undergoing cardiac valve replacement under CPB. Methods Twenty NYHA class Ⅱ - Ⅲ patients with rheumatic heart disease scheduled for elective cardiac valve replacement under CPB were randomly divided into 2 groups: midazolam group (M, n = 10) and propofol group (P, n = 10) . Patients with preoperative hepatic and renal dysfunction, coagulation defect and diabetes, primary hypertension and coronary artery disease were excluded. The patients were premedicated intramuscular morphine 0.1 mg?kg-1 and oral diazepam 0.1 mg?kg-1. Anesthesia was induced with midazolam 0.06-0.1 mg?kg-1 (group M) or propofol 1.0-1.5 mg?kg-1 (group P) and scopolamine 0.6 mg, fentanyl 4-10 ug?kg-1, vecuronium 0.1 mg?kg-1 and lidocaine 1.5 mg?kg-1, and maintained with intermittent iv boluses of midazolam 0.04-0.1 mg? kg-1 (group M) or propofol intravenous infusion at a rate of 3-5 mg?kg-1?h-1 supplemented with intermittent boluses of fentanyl and vecuronium. PETCO2 was maintained at 30-40 mm Hg during mechanical ventilation. BP, HR, ECG, CVP, PETCO2, SpO2 , nasal and rectal temperature were continuously monitored during operation. Blood samples were taken from artery before anesthesia (T1), at vena cava catheterization (T2), 30min after aortic cross-clamping (T3) and 10 min (T4), 1 h (T5), 2 h(T6), 4 h(T7) and 24 h(T8) after declamping of aorta for determination of Hct, IL-1, IL-8 and IL-10 by using ELISA. Results Plasma concentrations of IL-6, IL-8 and IL-10 were significantly increased at T4-7 as compared with the baseline value before anesthesia (T1) in both group. Plasma concentration of IL-8 in group P was significantly lower than that in group M at T7 ( P
