Cardioprotective Properties Of Sevoflurane In Patients Undergoing Mitral Valve Replacement With Cardiopulmonary Bypass

Objective: To investigate the protective properties of sevoflurane on myocardium in paitients undergoing mitral valve replacemen(tMVR)under cardiopulmonary bypass.Methods: Thirty ASAâ…¡orâ…¢patients scheduled for MVR surgery under cardiopulmonary bypass were randomly assigned to 2 groups (n=15):sevoflurane group(group S)and propofol group(group P).Anesthesia were maintained with intravenous infusion of propofol 4-6mg/kg/h and intermittent infusion of fentanyl in group P and with inhalation of 1%-3.0% sevoflurane and intermittent infusion of fentanyl in group S. Heart rate (HR),mean arterial pressure(MAP),central venous pressure (CVP),cardiac index(CI),and stoke volume index(SVI) were recorded before operation(Tbase) ,before the start of CPB(Tpre), after the end of CPB(Tpost),at arrival in the intensive care unit(T0) and 6 and 12 hours after arrival in ICU(T6,T12). Blood samples were taken before the operation(Tbase),T0,T6,T12,T24 and 48hours after arrival in ICU (T48)for determination of serum concentration of cTnI and CK-MB. The automatic rebeating rate was also recorded.Results: The two groups were comparable with respect to MAP, CVP and HR (P >0.05);CI and SVI were increased afer the end of CPB and at arrival in ICU in group S compared with in group P(P<0.05) Serum concentrations of cTnI and CK-MB were significantly lower postoperatively in group S than that in group P (P <0.05) . The automatic rebeating rate was singnificantly higher in group S compared with group P(P <0.05) .Conclusion: In MVR surgery patients, the use of a volatile anesthetic regimen was associated with preserved cardiac function after CPB and less postoperatively release of cTnI and CK-MB compared with a total intravenous anesthetic regimen.