Application Of Sevoflurane Anesthesia In The Cardiopulmonary Bypass

ObjectivesTo compare the effects of sevoflurane and propofol anesthesia on stress response and hemdynamics during cardiopulmonary bypass in patients undergoing cardiac valve replacement surgery and inquire into the better way of anesthesia maintainance during cardiopulmonary bypass.MethodsThirty patients which were ASAâ…¡-â…¢undergoing cardiac valve replacement surgery under cardiopulmonary bypass were divided into two groups randomly. Each group was composed of fifteen patients.Two groups were induced with midazolam, etomidate,fentany and vecuronium bromide,and maintained by combined anesthesia. During cardiopulmonary bypass period,Group S were inhaled sevoflurane 0.5%-3% from sevoflurane vaporizer on extracorporeal circulation machine without propofol;Group P were infused propofol(6-10mg/kg/h) without sevoflurane. The data,including serum concentration of adrenaline,HR,MAP were recorded at designated time points:before CPB(T1), after blocked aorta 10 min(T2),after opened aorta 10 min (T3), the operation lasted 24h(T4). Paitents'blood samples were taken at T1-T4 by radial artery to determine serum concentration of adrenaline and cortisol. Paitents'time of CPB,recovery of heart beating, aortic clamping, hospitalization 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 at each time point between Group S and Group P (P>0.05).While intra-group comparisons showed significant differences at T1,T2 and T3(P<0.05), The MAP decreased at T2 compareing with Tland increased at T3 compareing with T2;and HR increased at T3 compareing with T1,so significant differences were showed (P<0.05).3.The serum concentration of adrenaline and cortisol at all time point were all no obvious differences between Group S and Group P (P> 0.05).In the intra-group comparisons of the cortisol of two groups at each time point there were significant differences(P<0.05).The T2 ascended compareing with T1 in the intra-group comparisons of the adrenaline of group P(P<0.05). The T2 ascended compareing with T1,meantime the T3 ascended compareing with T2 and T4 in the intra-group comparisons of the adrenaline of group S(P<0.05).Conclusion 1. Sevoflurane, propofol could be used during the CPB in which hemdynamics were stabilized.2. There were no obvious differences in the effects on controlling stress response between sevoflurane and propofol during the CPB.3 Because of myocardial protection convenient operation,etc, sevoflurane anesthesia was more suitable for anesthesia maintainance than propofol anesthesia during the CPB...