The Effects Of Different Anesthesia Methods With Propofol,Sevoflurane Or Propofol Combined With Sevofiurane On Myocardial Ischemia-reperfusion Injury

Objective To compare the effect of different anesthesia methods withpropofol,sevoflurane or propofol combined with sevoflurane on myocardialischemia-reperfusion injury.Methods45patients acctepted the mitral valve replacement surgery were randomlyassigned to propofol group （P）, sevoflurane group （S） or propofol combined withsevoflurane group （PS） with15cases each. Heart rate （HR）, mean arterial pressure （MAP）,central venous pressure （CVP） were recorded before surgery, before CPB, after CPB and atthe end of surgery. Atrerial blood levels of cardiac troponin I （cTnI）,creatine kinaseisoenzyme （CK-MB）, malondialdehyde （MDA） and superoxide dismutase（SOD） weredetermined before induction of anesthesia （T0）,such as at2h（T₁）,4h（T₂）,8h（T₃）,24h（T₄）and48h（T₅）after the ascending aorta open.Results The plasma CtnI concentration and CK-MB activity concentration weresignificantly increased at T₁,T₂,T₃,T₄,T₅. Compared to group P and group PS, theplasma cTnI concentration of group S were lower at T₁,T₂,T₃,T₄,T₅（P <0.05） whilethe plasma CK-MBactivity significantly lower （P <0.05） at T₂,T₃,T₄,T₅. The plasmaSOD concentration was significantly decreased at T₁,T₂,T₃,T₄. Compared to group P andgroup PS, the plasma MDA concentration of group S at T₁,T₂,T₃,T₄, respectively,significantly were lower while the plasma SODactivity significantly higher. Conclusion1. These three anesthetic methods can be safely applied to rheumatic mitral valvereplacement surgery.2.Myocardial cells and cardiac function were suffered some degree of damageafter ischemic reperfusion occurred in patients with rheumatic mitral valve replacementsurgery.3. The myocardial ischemia reperfusion injury was lighter in patiets with mitralvalve replacement who used sevoflurane inhalation anesthesia while the artificialmembranes lung used during cardiopulmonary bypass.These patiets also had betterpostoperative outcomes.