Abstract:
Objective: To observe the effects of sevoflurane post-processing on the relative index of myocardial enzyme in patients treated with heart valve replacement under cardiopulmonary bypass(CPB).
Methods: Seventy-two rheumatic heart disease patients treated with heart valve replacement under CPB were randomly divided into the sevoflurane post-processing group(group S) and control group(group C)(36 cases each group).The group S were treated with the 2% of sevoflurane by cardiopulmonary bypass into blood circulation for 15 minutes at the time of aorta opening,the group C were treated with intravenous anesthesia.The jugular venous blood was collected before anesthesia induction(T
0),after 30 min(T
1),3h(T
2) and 24h(T
3) of aorta opening,and centrifuged for 10min,the supernatant of which was stored at -20℃.The serum levels of cardiac troponin(cTnI),creatine kinase(CK),creatine kinase(CK-MB) and lactate dehydrogenase(LDH) were meaured and compared at four time points.
Results: Compared at T
0,the levels of cTnI,CK,CK-MB and LDH in two groups significantly increased at T
1,T
2 and T
3(
P<0.01).The levels of cTnI at T
3,CK at T
2 and T
3,CK-MB at T
1 and LDH at T
1,T
2 and T
3 in group S were significantly lower than those in group C(
P<0.01 and
P<0.05).The differences of gerenal condition and total amount of dopamine using between two groups were not statistically significant(
P>0.05).
Conclusions: Sevoflurane post-processing can reduce the myocardial enzyme releasing in patients treated with heart valve replacement under cardiopulmonary bypass,alleviate the injury of myocardial ischemia-reperfusion and protect the myocardum.