Changes of plasma cytokines and myocardial enzymes in different doses of fentanyl in patients undergoing valve replacement
- VernacularTitle:不同剂量芬太尼复合麻醉下心脏瓣膜置换术患者围术期血浆细胞因子和心肌酶的变化
- Author:
Jianhua LIU
;
Jinmei SHEN
;
Li LI
- Publication Type:Journal Article
- Keywords:
Fentanyl;
Heart valve prosthesis implantation;
Cytokines;
Creatine kinase
- From:
Chinese Journal of Anesthesiology
1997;0(11):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the changes of plasma cytokines and myocardial enzymes in different doses of fentanyl in patients undergoing valve replacement under cardiopulmonary bypass (CPB) and evaluate its anti-inflammatory and myocardial protective effects.Methods Thirty ASAⅡ-Ⅲ patients undergoing elective valve replacement under CPB were studied. We excluded patients having infection, abnormal immunological function of receiving steroid or immune- modulatory drugs. The patients were premedicated with intramuscular phenobarbital 0.1 g and scopolamine 0.3 mg. Anesthesia was induced with midazolam modulate 0.1 mg ?kg-1 , fentanyl 10 ?g?kg-1 and vecuronium 0.1 mg?kg-1 and maintained with continuous infusion of fentanyl and intermittent i.v. boluses of midazolam and vecuronium. The total dose of fentanyl amounted to 30, 60 and 100 ?g?kg-1 (group 1, 2 and 3, n = 10) and was infused before CPB was started. MAP, CVP, HR, ECG, SpO2, PETCO2 and naso-pharyngeal and rectal temperature were continuously monitored during operation. Blood samples were taken before anesthesia (T1 ,baseline) , before CPB (T2 ) , 30 min and 2 h after release of aortic cross-clamping (T3 , T4 ) and 24 h after operation (T5 ) for determination of plasma levels of TNF-?, IL-6, IL-10 and creatine kinase (CK) and CK-MB activity.Results The three groups were comparable with respect to age, body weight, aortic cross-clamping time, CPB time and duration of operation. The plasma levels of TNF-?, IL-6, IL-10, CK and CK-MB activities were significantly increased after CPB compared to baseline (T1) (P
