七氟醚与丙泊酚麻醉对老年冠心病非心脏手术患者血流动力学心肌保护及不良事件的影响

doi:10.3969/j.issn.1006-6233.2022.02.030

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Abstract Objective: To explore the effects of sevoflurane anesthesia and propofol anesthesia on hemodynamics, myocardial protection and adverse events in elderly patients with coronary heart disease undergoing non-cardiac surgery. Methods: A total of 132 elderly patients with coronary heart disease admitted to the hospital between September 2017 and September 2020 were selected as the research subjects, and they were simply randomly divided into sevoflurane group (n=66) and propofol group (n=66), and respectively given continuous inhalation of 3% sevoflurane and continuous infusion of 3 μg/ml propofol for anesthesia during non-cardiac surgery. The surgical status, myocardial markers, hemodynamic parameters and occurrence of cardiac adverse events and other adverse events were compared between the two groups. Results: The awake time, extubation time and transfusion volume of sevoflurane group were significantly shorter or less than those of propofol group (P<0.05). Immediate measure after surgery showed that the level of cardiac troponin I (cTnI) was significantly lower in sevoflurane group than that in propofol group (P<0.05). The levels of cTnI and creatine kinase-MB (CK-MB) in sevoflurane group at 12h and 24h after surgery were significantly lower than those in propofol group (P<0.05). At T1, the SBP of sevoflurane group was significantly higher compared to propofol group (P<0.05). At T2, the heart rate (HR) of sevoflurane group was significantly lower than that of propofol group while the systolic blood pressure (SBP) was significantly higher than that of propofol group (P<0.05). At T3, the SBP was significantly higher in sevoflurane group compared with that in propofol group (P<0.05). At T4, the HR of sevoflurane group was significantly lower while the SBP and diastolic blood pressure (DBP) were significantly higher compared to propofol group (P<0.05). At T5, the SBP and DBP in sevoflurane group were significantly higher than those in propofol group (P<0.05). The total incidence rate of adverse cardiac reactions was 10.61% in sevoflurane group, which was significantly lower than 28.79% in propofol group. The total incidence rate of other adverse reactions in sevoflurane group was significantly higher than that in propofol group (19.70% vs 6.06%) (P<0.05). Conclusion: Sevoflurane for anesthesia has a more stable hemodynamic effect and shorter anesthesia time and recovery time in elderly patients with coronary heart disease undergoing non-cardiac surgery, and it better protects the myocardium and has less transfusion volume and lower incidence of cardiac adverse events. But it is prone to adverse events such as nausea and vomiting, thus it is suitable for patients with fear of injections, potential airway difficulties and heart risks.

Key words： Sevoflurane Propofol Coronary heart disease Hemodynamics Myocardial protection Adverse events

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	SHI Gaoyang
	HUANG Liangcheng
	GAN Changcai

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SHI Gaoyang,HUANG Liangcheng,GAN Changcai. Effects of Sevoflurane Anesthesia and Propofol Anesthesia on Hemodynamics Myocardial Protection and Adverse Events in Elderly Patients with Coronary Heart Disease Undergoing Non-Cardiac Surgery[J]. HeBei Med, 2022, 28(2): 322-327.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2022.02.030 OR http://www.hbyxzzs.cn/EN/Y2022/V28/I2/322

[1] Zhang Y,Lin W,Shen S,et al.Randomized comparison of sevoflurane versus propofol-remifentanil on the cardioprotective effects in elderly patients with coronary heart disease[J].BMC Anesthesiol,2017,17(1):104.
[2] Sashindranath M,Sturgeon S A,French S,et al.The mode of anesthesia influences outcome in mouse models of arterial thrombosis[J].Res Pract Thromb Haemost,2019,3(2):197~206.
[3] Dai Z L,Cai X T,Gao W L,et al.Etomidate vs propofol in coronary heart disease patients undergoing major noncardiac surgery:a randomized clinical trial[J].World Clin Cases,2021,9(6):1293~1303.
[4] 张莹莹,唐菁,刘双双,等.七氟醚不同吸入时长对非心脏手术老年冠心病患者心肌的保护作用[J].重庆医学,2020,49(6):933~937.
[5] 郭靖涛,李文泽,张来军.实用心脏内科学[M].科学技术文献出版社,2013.332~341.
[6] 胡翠纹,郭轩,张琪,等.美国麻醉医师协会体质分级对老年手术患者心脏自主神经功能的评价意义[J].中华老年心脑血管病杂志,2021,23(5):491~494.
[7] 刘乐义,刘子嘉,许广艳,等.修订的心脏风险指数对老年冠心病患者非心脏手术围手术期主要心脏不良事件的临床评估价值[J].中国医学科学院学报,2020,42(6):732~739.
[8] Ren L,Sun X,Guan Y,et al.Effects of sevoflurane or propofol combined with remifentanil anesthesia on clinical efficacy and stress response in pregnant women with pregnancy-induced hypertension.[J].Eur rev med pharmacol sci,2018,22(6):1825~1829.
[9] 国松,姜万维,郭旭东,等.不同靶浓度丙泊酚复合瑞芬太尼与七氟醚复合瑞芬太尼静吸麻醉用于腹腔镜胆囊切除术的观察[J].河北医学,2021,27(1):33~37.
[10] 安彬,陶德强,杨占民.七氟醚复合丙泊酚麻醉对冠心病患者术后血流动力学及NT-proBNP水平的影响[J].中国循证心血管医学杂志,2019,11(8):989~991.
[11] Han Y,Han L,Dong M,et al.Comparison of a loading dose of dexmedetomidine combined with propofol or sevoflurane for hemodynamic changes during anesthesia maintenance:a prospective,randomized,double-blind,controlled clinical trial[J].Bmc Anesthesiol,2018,18(1):12.
[12] 付鹏,马平,李振辉.七氟醚对合并冠心病腹腔镜胆囊切除患者cTnI、GP-BB的影响及预后分析[J].中国医药导报,2018,15(19):109~112.