The Effects Of TNF-α,cTnI With Different Ways Of Sevoflurane Inhalation Anesthesia In Pediatric Open Heart Surgery

Objective The purpose of this study was to investigate the change of TNF-α,cTnI with different ways of sevoflurane Inhalation Anesthesia in pediatric open heart surgery,Discussion the cardiac protective effect of different ways of sevoflurane inhalation anesthesia in pediatric open heart surgery.Methods Thirty-three cases of congenital heart disease with interatrial septum,or ventricular septum,defect undergoing open heart surgery with CPB were performed interatrial septum or ventricular septal defect repair through meso or right-armpit incision.They were ASAⅠ～Ⅱ,heart functionⅠ～Ⅱ,age3～12,body weight 12～30kg before operation.Randomly divided into control group(A group),continued inhalation of sevoflurane group(B group), intermittent inhaled sevoflurane group(C group).Collecting blood samples when induction (T1),after the shutdown 2h(T2),after the shutdown 6h(T3),post-operative 24h(T4) blood. tumor necrosis factor(TNF-α) in blood serum were measured at T₁,T₂ and T₃,and cardiac protonin-I(cTnI) in blood serum were measured at T₁,T₃ and T₄.During operation,recorded and observed heart rate before pericardial incision,cardiopulmonary bypass time,auto-jump and defibrillation,arrhythmia and the dosage ofvasoactive drugs used during operation.Results All pre-anaesthesia indices of four groups were comparable,no significant difference(P＞0.05).The concentration of TNF-α:T₁ was higher than T₂ in each group(P＜0.05), T₃ was higher than T₁ in group A(P＜0.05),and there was no significant difference between T₂ and T₃(P＞0.05);T₃ was lower than T₂ in Group B and Group C(P＜0.05),and there was no significant difference in T₁ and T₃(P＞0.05);Compared with the three groups,there's no significant difference in T₁.The T₂,T₃ of group B and group C were lower than A group's(P＜0.01),there's no statistical significance between group B and groups C at each time point(P＞0.05).The concentration of cTnI:cTnI increased significantly after release of aortic cross-clamp in each group compared with the baseline values at T₁(P＜0.01);Group B's T₃,T₄ were lower than Group C's,T₃.there was no significant difference between Group B and Group C(P＞0.05),while the C group's T₄ was lower than group B's(P＜0.05).There was no difference in heart rate before pericardial incision,auto-jump,defibrillation,arrhythmia and the dosage of vasoactive drugs used during operation among the three groups(P＞0.05).Conclusion There were a series of myocardial injury The pediatric open heart surgery,The inhalation of 2%sevoflurane could reduce the inflammatory response and reduce ischemia -reperfusion myocardial injury,intermittent and continuous inhalation of the same concentration of sevoflurane had protective effects on myocardial,and intermittent inhalation of sevoflurane probably had a better results.