Effects Of Sevoflurane And Propofol On Postoperative Recovery In Cardiac Valve Replacement Patients Undergoing Cardiopulmonary Bypass

Objective To compare the effects of sevoflurane inhalation anesthesia and propofol intravenous anesthesia on postoperative recovery of patients undergoing cardiac valve replacement under cardiopulmonary bypass.Methods A total of 50 patients who underwent cardiopulmonary bypass in the Ningxia medical university hospital from January 2018 to December 2018 were selected and included in the exclusion criteria.ASA grades III to IV were randomly divided by random number table method.Sevoflurane group（S group,n=25）and propofol group（P group,n=25）, group S was given sevoflurane to maintain anesthesia（continuous inhalation of sevoflurane during operation 1%to 5%）,P The group was given propofol for anesthesia(intraoperative continuous intravenous pumping of propofol 3 to 8 mg·kg^-1·h^-1).The depth of anesthesia was monitored by BIS instrument during the operation between 40 and 60,and surgery was started separately Venous blood before（T0）,at the end of CPB（T1）,and 1 day after operation（T2）,the serum levels of IL-6 and IL-10 were measured by ELISA,and perioperative hemodynamics were recorded before CPB,15 minutes after CPB shutdown,perioperative period after surgery,blood glucose and lactic acid content before,24h,48h,72h after surgery,CPB time,operation time,mechanical ventilation time,ICU stay time,length of hospital stay and total cost of hospitalization,quality of life questionnaire was used to assess recovery within 1 year after surgery,and mortality within 1 year after surgery.Results There was no significant difference in general information between the two groups of patients（P>0.05）;the levels of IL-6 and IL-10 in group S were lower than those in group P at the end of CPB and 1 day after surgery（P<0.05）.The levels of IL-6 and IL-10 in the two groups were higher than those before surgery have significant differences（P<0.01）.The lactate content in group S was lower than that in group P and has statistic difference（P<0.05）,and there was no statistically significant difference between the two groups of patients before surgery.The glucose level of the two groups has no statistically significant difference（P>0.05）.There was no significant difference in heart rate between the two groups at each time point（P>0.05）.The MAP of group S was higher than that of group P at the end of CPB and after surgery（P<0.05）.The difference in CVP between the two groups at different time points has no statistic meaning（P>0.05）.The patients in group S have the less time of mechanical ventilation,the length of ICU stay,the length of hospital stay,the length of hospital stay and the total cost compared with group P（P<0.05）.The Quality of Life Questionnaire SF-8TM scores were higher in group S in 1,3,6 and 12 months than the group P in statistics（P<0.05）.The death rate in group S was slightly lower than group P but has no statistical difference（P>0.05）.Conclusion Sevoflurane anesthesia can reduce inflammation more during cardiac valve replacement surgery under cardiopulmonary bypass,and shorten mechanical ventilation time,ICU stay time,reduce the days in hospital,and reduce the total cost of hospitalization.Meanwhile sevoflurane anesthesia can reduce the death rate within 1 year after surgery,not only be more conducive to postoperative recovery,but also improve the postoperative quality of life.