The Effect Of Sevoflurane On Troponin â…  During Cardiopulmonary Bypass

ObjectivesTo investigate the effects of cardiopulmonary bypass period induced by sevoflurane versus propofol anesthesia on cardiac troponin I and hemdynamics in patients undergoing cardiac valve replacement.MethodsThirty patients which were ASAⅡ-Ⅲundergoing cardiac valve replacement with cardiopulmonary bypass were divided into tow groups randomly.Group I was composed of fifteen patients undergoing sevoflurane and the other fifteen paitents named GroupⅡwere used propofol during cardiopulmonary bypass period.Anesthesia induced with midazolam, etomidate,fentany and vecuronium bromide,and maintained by combined anesthesia. GroupⅠwere inhaled sevoflurane 1%～3% by sevoflurane vaporizer on extracorporeal circulation machine and GroupⅡwere used propofol during cardiopulmonary bypass period.The data,included CTnⅠ,HR,MAP were recorded at designated time points:before anesthesia(TO),before CPB(T1),after CPB 1h(T2),the operation lasted 4h(T3) and 24h(T4). Paitents'blood samples were taken 5ml at T0-T4 by radial artery and deal with by ELISA to assaying cTn I.Paitents'time of CPB,recovery of heart beating, aortic clamping and operation were also recorded.Results1.There were no differences in patients'age, weight, time of CPB,aortic clamping, operation,time in hospital and the way of operation (P>0.05).2.The MAP and HR were no remarkable differences among each time point between two group (P>0.05).And intra-group comparisons showed significant differences at TO,T1 and T2(P<0.05).The MAP,HR increased at T1 and decreased at T2.No differences were indicated at T2,T3 and T4 (P>0.05).3.The CTn I were no obvious differences in the interior-group (P> 0.05).In the intra-group each time point showed significant differences(P< 0.05).The T2 ascended compareing with TO and T3 was climax,but T4 descended the level of T0.Conclusion1. Cardiopulmonary bypass could lead to myocardial ischemic reperfusion injury.2. Sevoflurane and propofol could used to CPB and hemdynamics were stabilized.3. The effects of myocardial protection during cardiopulmonary bypass period induced by sevoflurane were better than propofol.It characterized CTn I reduced.