The Effects Of CTnI,CK-MB With Sevoflurane Combined Anesthesia On Patients With Cadiac Valve Replacement

Objective:To investigate the effects of cTnI,CK-MB with sevoflurane combined anesthesia on patients with cadiac valve replacement under cardiopulmonary bypass,observe the myocardio pretective effects with sevoflurane combined anesthesia.Methods:Twenty-four patients with cadiac valve replacement under cardiopulmonary bypass were randomly divided into two groups of twelve patients:contrast group and sevoflurane group.In sevoflurane group,the vaporizer was adjusted 6%from the beginning of induction to the ending of induction and 2%～3%from the ending of induction to the beginning of CPB,before CPB,the vaporizer was shut off.HR,SBP,DBP,MAP were recorded before anesthesia(t₁),before intubation(t₂),2 min after intubation(t₃),2 min after incision(t₄),2 min after cut the sternum(t₅).The venous blood samples were collected or the measurements of CK-MB and cTnI before anesthesia(T₁),2h(T₂),4h(T₃),8h(T₄),24h(T₅) after release of aortic cross-clamp.Results:1.HR,SBP,DBP,MAP:group comparison:There were no significant differences in HR,SBP,DBP,MAP among the two groups(P＞0.05);comparison within group:SBP,DBP,MAP decreased significantly after anesthesia induction in each group compared with the baseline values at t₁(P＜0.05),and stepped up after tracheal intubation,difference between maximum values and baseline values were not statistically significant but SBP.2.There were no significant differences in time of CPB and aortic cross-clamp among the two groups(P＞0.05);There were no significant differences in the rate of automatic beat,There were significant differences in the rates of electric defibrillation,ventricular arrhythmia,in sevoflurane group,the rates of electric defibrillation,ventricular arrhythmia are lower(P＜0.05).3,cTnI:group comparison:There were significant differences among the two groups but T₁(P＜0.05);comparison within group:cTnI increased significantly after release of aortic cross-clamp in each group compared with the baseline values at T₁(P＜0.01);comparison of interaction:There were no significant differences in the contrast group and the sevoflurane group,(P＞0.05);CK-MB:group comparison:There were significant differences among the two groups but T₁,T₂(P＜0.01);comparison within group: CK-MB increased significantly after release of aortic cross-clamp in each group compared with the baseline values at T₁(P＜0.01);comparison of interaction:the contrast group increased more quickly than the sevoflurane group,the differences were statistically significant(P＜0.01).Conclusion:sevoflurane combined anesthesia is safe and efficacious and provides greater protection of the myocardium on patients with cadiac valve replacement under cardiopulmonary bypass.