Comparison of the myocardial protective effect of sevoflurane versus propofol in patients undergoing heart valve replacement surgery with cardiopulmonary bypass

• Published in: BMC anesthesiology 2017-03, Vol.17 (1), p.37-37, Article 37
• Main Authors: Yang, Xiao-Lin, Wang, Dan, Zhang, Guo-Yuan, Guo, Xiao-Lan
• Format: Article
• Language: English
• Subjects: Anesthesia; Anesthesiology; Anesthetics, Inhalation - pharmacology; Anesthetics, Intravenous - pharmacology; Aorta; Biomarkers - blood; Bypasses; Calcium-binding protein; Cardiopulmonary bypass; Cardiopulmonary Bypass - methods; Cardiovascular disease; Comparative analysis; Coronary vessels; Creatine; Creatine kinase; Creatine Kinase, MB Form - blood; Cytokines; Dosage and administration; Female; Heart; Heart diseases; Heart surgery; Heart Valve Prosthesis Implantation - methods; Heart valve replacement; Hospitals; Humans; Inflammation; Inflammatory response; Inhalation; Intensive care; Interleukin 10; Interleukin 6; Interleukin-10 - blood; Interleukin-6 - blood; Intravenous administration; Intravenous infusion; Length of Stay - statistics & numerical data; Male; Methyl Ethers - pharmacology; Middle Aged; Myocardium - metabolism; Patient outcomes; Propofol; Propofol - pharmacology; Protective Agents - pharmacology; Respiration; Retrospective Studies; Sevoflurane; Studies; Time Factors; Troponin; Troponin I; Troponin I - blood; Ventilators
• ISSN: 1471-2253; 1471-2253
• DOI: 10.1186/s12871-017-0326-2

This study aimed to compare myocardial protective effects of anaesthesia with intravenous infusion of propofol versus inhalation of sevoflurane in patients undergoing heart valve replacement surgery with cardiopulmonary bypass. Seventy-six patients undergoing valve replacement with cardiopulmonary bypass were randomly assigned to propofol or sevoflurane anesthesia during the surgery, respectively. For assessing myocardial injury, cardiac troponin I (cTnI) and creatine kinase isozyme (CK-MB) were determined before induction (T ), 0.5 h (T ) and 3 h (T ) after aortic unclamping, and 24 h (T ) and 48 h (T ) after surgery. The concentrations of interleukin (IL)-6 and IL-10 as the systemic inflammatory and anti-inflammatory markers were also measured at above time points. In the sevoflurane group, the plasma concentrations of cTnI and CK-MB from T to T and the levels of IL-6 and IL-10 from T to T were lower than those in the propofol group. Moreover, a higher ratio of automatic heart beat recovery and a shorter length of intensive care unit or hospital stay were found in the sevoflurane group comparing with the propofol group. Sevoflurane anaesthesia produced more prominent myocardial protection and attenuated inflammatory response than propofol anaesthesia in patients with valve replacement surgery under cardiopulmonary bypass, resulting in shorter ICU and in-hospital stay. Identified as ChiCTR-IOR-16009979 at http://www.chictr.org.cn/ .