Comparison Of Myocardial Protection Between Propofol And Sevoflurane In Patients Undergoing Valve Replacement With Cardiopulmonary Bypass

Objective To compare the different levels of cTn-I, CK-MB, IL-6,IL-10between intravenous (IV) infusion of propofol and inhaled sevofluraneanesthesia,and evaluate their myocardial protection in patients undergoingunivalve replacement with cardiopulmonary bypass.Methods Fifty patients with ASA Ⅱ~Ⅲ, undergoing valvereplacement with cardiopulmonary bypass, were randomly assigned to twogroups (25patients in each group). IV infusion of Propofol (group P) andinhaled sevoflurane (group S) were applied to maintain anesthesia in the twogroups, respectively. Plasma concentrations of cardiac troponin I (cTnI),Creatine kinase (CK-MB), interleukin-6(IL-6) and interleukin-10(IL10) weremeasured at the time points of before anesthesia (T0),0.5h (T1),3h (T2),24h (T3) and48h（T4）after aorta had been opened.Results (1)In each group, compared with their preoperative basevalues, the plasma concentrations of cTnI and CK-MB increased significantlyat all the four time points, and the value at T2was the highest (P <0.01). Theplasma concentrations of IL-6and IL-10increased significantly at Tl-T3andreached the maximum at T2(P <0.01).(2) Compared with the propofol groupat corresponding time points, both the values of CTnI and CK-MB in thesevoflurane group were lower from Tlto T4(P <0.01)；and the values of IL-6and IL-10at T1and T2were also less than those in the propofol group atcorresponding time points(P <0.05). Conclusion To the patients undergoing valve replacement withcardiopulmonary bypass, both IV infusion of propofol and inhaledsevoflurane to maintain anesthesia are safe, but the myocardial protectiveeffect of sevoflurane is more obvious than that of propofol.