地氟烷在二尖瓣置换手术中对缺血再灌注心肌的保护作用

在心脏外科手术中心肌缺血再灌注(ischemia-reperfusion,I-R)损伤的防治是急需解决的问题。缺血预处理(ischemic preconditioning,IPC)具有心肌保护作用[1,2]。研究显示挥发性麻醉药也具有类似IPC的麻醉药预处理(anesthetic-induced preconditioning,APC)作用[3,4],能减轻I-R后

Protective effects of desflurane on ischemia-reperfusion induced myocardium injury in patients undergoing mitral valve replacement

Objective To investigate the effects of desflurane on ischemia-reperfusion induced myocardium injury in patients undergoing mitral valve replacement. Methods Thirty patients scheduled for mitral valve replacement with cardiopulmonary bypass (CPB) were randomly assigned to receive either infusion of propofol or inhalational anesthetic of desflurane as part of a fentanyl-based anesthetic regimen. Systemic hemodynamic variables and cardiac function were measured perioperatively using pulse-induced contour cardiac output (PiCCO) technique. For assessing myocardial injury, cardiac troponin I (cTnI) and myocardial fraction of creatine kinase (CK-MB) were determined during the first 48 postoperative hours. Results After CPB, the cardiac index and stroke volume index in desflurane group were recovered earlier than the propofol group. And they were significantly higher in desflurane group than in propofol group during the first 6 postoperative hours. Concentration of cTnI and CK-MB increased significantly in propofol group as compared with those in desflurane group. Conclusion Desflurane has protective effects on ischemia-reperfusion induced myocardium injury in patients undergoing mitral valve replacement.