Effect of sevoflurane combined with thoracic epidural anesthesia on myocardial injury in patients undergoing off-pump coronary artery bypass grafting
Zhang Yixuan, Yan Zeng, Xin Wenqi, Zhang Zhi, Ma Chuan'gen
Published 2014-05-08
Cite as Chin J Exp Surg, 2014,31(05): 1135-1137. DOI: 10.3760/cma.j.issn.1001-9030.2014.05.073
Abstract
Objective To investigate the effects of sevoflurane combined with thoracic epidural anesthesia on myocardial injury in patients undergoing off-pump coronary artery bypass grafting.Methods Forty consenting USA society of Anesthesiologists score standard (ASA) Ⅱ or Ⅲ patients undergoing offpump coronary artery bypass grafting were randomly divided into 2 groups (rt =20 each):The patients in SE group were given thoracic epidural anesthesia plus general anesthesia with 0.25% levobupivacaine hydrochloride injection as the study group.The patients in the control group received general anesthesia only.4 ml of blood samples were taken from the central vein before skin incision (T0),at the end of operation (T1),and 4 h (T2),8 h (T3),12 h (T4) and 24 h (T5) after operation for determination of the concinase (CK)and creatin kinase isoenzyme-MB (CK-MB).Results The concenentration of serum cardiac troponin I (cTnI) at T2-T5 was (5.45 ± 1.85),(7.34 ± 1.88),(7.29 ± 1.86) and (6.85 ± 1.89) μg/L respectively in SE group,significantly lower than in the control group.The concenentration of serum CK at T2-T5 was (35 ±5),(42 ±8),(54 ±9) and (52 ±9) U/L,significantly lower in SE group than in the control group (P < 0.05).The concenentration of serum CK-MB at T2-T5 was (3.4 ± 1.1),(4.6 ± 1.9),(3.8 ± 1.5)and (1.5 ± 0.8) U/L respectively,significantly lower in SE group than in the control group (P < 0.05).Conclusion Sevoflurane combined with thoracic epidural anesthesia can attenuate the myocardial injury in patients undergoing off-pump coronary artery bypass grafting.
Key words:
Sevoflurane; Epidural anesthesia; Off-pump coronary artery bypass grafting; Myocardial injury
Contributor Information
Zhang Yixuan
Department of Anesthesiology, Huaihe Hospital, He'nan University, Kaifeng 475000, China
Yan Zeng
Department of Anesthesiology, Huaihe Hospital, He'nan University, Kaifeng 475000, China
Xin Wenqi
Department of Anesthesiology, Huaihe Hospital, He'nan University, Kaifeng 475000, China
Zhang Zhi
Department of Anesthesiology, Huaihe Hospital, He'nan University, Kaifeng 475000, China
Ma Chuan'gen
Department of Anesthesiology, Huaihe Hospital, He'nan University, Kaifeng 475000, China