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Randomized Controlled Trial
. 2017 Mar 4;17(1):37.
doi: 10.1186/s12871-017-0326-2.

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

Xiao-Lin Yang  1 , Dan Wang  2 , Guo-Yuan Zhang  3 , Xiao-Lan Guo  3
Affiliations
Randomized Controlled Trial

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

Xiao-Lin Yang et al. BMC Anesthesiol. .

Abstract

Background: 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.

Methods: 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 (T0), 0.5 h (T1) and 3 h (T2) after aortic unclamping, and 24 h (T3) and 48 h (T4) 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.

Results: In the sevoflurane group, the plasma concentrations of cTnI and CK-MB from Tl to T4 and the levels of IL-6 and IL-10 from T1 to T2 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.

Conclusion: 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.

Retrospective clinical trial registration: Identified as ChiCTR-IOR-16009979 at http://www.chictr.org.cn/ .

Keywords: Cardiopulmonary bypass; Heart valve replacement; Myocardial protection; Propofol; Sevoflurane.

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Figures

Fig. 1
Fig. 1
The changes of auditory evoked potential index (AEPi) in the two groups. The changes of AEPi were kept similar in pre-anaesthesia, intubation, pre-CPB, during CPB, after CPB and the end of operation between the two groups, respectively. CPB = Cardiopulmonary bypass
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