七氟醚与丙泊酚麻醉对心内直视手术患者应激反应的影响

目的比较七氟醚吸入麻醉与丙泊酚静脉麻醉对心内直视手术患者CPB期间应激反应的影响。方法择期行心脏直视手术患者40例,ASAⅡ或Ⅲ级,随机均分为七氟醚组(S组)和丙泊酚组(P组)。记录诱导前(T0)、气管插管后5min(T1)、CPB后30min(T2)、CPB结束(T3)、术毕(T4)MAP、HR、BIS及血浆促肾上腺皮质激素(ACTH)和皮质醇(Cor)含量。结果与T0时比较,T1时两组MAP、BIS、ACTH、Cor均降低(P<0.05),T2～T4时ACTH、Cor均明显升高(P<0.01)。T2、T3时P组MAP、BIS、ACTH、Cor显著高于S组(P<0.05)。结论心内直视手术CPB期间七氟醚吸入麻醉较之丙泊酚静脉麻醉可显著降低机体应激反应。

Effect of sevoflurane and propofol on stress response in patients undergoing open heart surgery

Objective To investigate the effect of sevoflurane anesthesia and propofol anesthesia on endocrine stress response in patients undergoing open heart surgery during cardiopulmonary bypass(CPB).Methods Forty ASA Ⅱ or Ⅲ patients were randomly allocated to one of two groups(n=20):sevoflurane anesthesia group(group S) and propofol anesthesia group(group P).MAP,HR,BIS,plasma concentration of adrenocorticotropic hormone(ACTH) and cortisol(Cor),were recorded before induction(T0),at 5 min after intubation(T1),at 30 min after the initiation of CPB(T2),at the end of CPB(T3) and operation(T4).Results Compared with T0,MAP,HR,BIS,and levels of ACTH and Cor,decreased significantly at T1(P < 0.05) while ACTH and Cor increased significantly at T2-T4(P < 0.01) in both groups.MAP,BIS,and levels of ACTH and Cor,in group P were significantly higher than those in group S at T2-T3(P < 0.05).Conclusion Sevoflurane inhalation anesthesia can more effectively inhibit the stress response in patients undergoing open heart operation during CPB than propofol anesthesia.