RT Journal Article
SR Electronic
T1 Effect of sevoflurane combination with epidural anesthesia on myocardial injury in patients with coronary artery disease undergoing non-cardiac surgery.
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 1009
OP 1016
VO 32
IS 10
A1 Yu, Jian-Bo
A1 Gong, Li-Rong
A1 Wang, Jing
A1 Wang, Man
A1 Zhang, Lan-Fang
A1 Li, Li
YR 2011
UL http://smj.org.sa/content/32/10/1009.abstract
AB OBJECTIVES: To determine the effect of sevoflurane combination with epidural anesthesia on myocardial injury in patients with coronary artery disease (CAD) undergoing non-cardiac surgery.METHODS: The investigation was performed in TianJin NanKai Hospital, TianJin, China from November 2009 to March 2010. Eighty patients with CAD undergoing elective abdominal surgery were randomized into 4 groups: group S1- combined sevoflurane general and epidural anesthesia; group S2 - standard sevoflurane general anesthesia; group P1 - combined propofol general and epidural anesthesia; and group P2 - standard propofol general anesthesia. Mean arterial pressure, central venous pressure, electrocardiogram, and bispectral index was monitored throughout the surgery. The serum levels of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha TNF-alpha, cardiac troponin I (cTnI), and glycogen phosphorylase BB (GP-BB) was measured at different time points during surgery.RESULTS: The ST depression in group P1 and S2 was significantly higher than that in group S1 (p=0.000) and lower than that in group P2 (p=0.00). The serum levels of IL-6, IL-8, TNF-alpha, cTnI, and GP-BB in group P1 and S2 were dramatically greater than that in group S1 (p=0.00), and lower than that in group P2 (p=0.00).CONCLUSIONS: Sevoflurane in combination with continuous epidural anesthesia could protect against myocardial damage in patients with CAD, downregulation of IL-6, IL-8, and TNF-alpha might contribute to this protection.