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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2015年第1期

页码:

83-084,091

栏目:

临床研究

出版日期:

2014-09-25

文章信息/Info

Title:

Effects of sevoflurane and propofol anesthesia on reaction of oxidative stress in immature myocardia

作者:

蒋海斌; 张铁峰; 李 颖; 张 蕾; 郭宙平

(兰州市第一人民医院麻醉科,甘肃 兰州 730050)

Author(s):

JIANG Hai-bin;  ZHANG Tie-feng;  LI Ying;  ZHANG-lei;  GUO Zhou-ping

(Department of Anesthesiology, First People’s Hospital, Lanzhou 730050, Gansu, China)

关键词:

七氟醚; 未成熟心肌; 丙二醛; 超氧化物歧化酶

Keywords:

sevoflurane;  immature cardiac myocytes;  malondialdenhyde;  superoxide dismutase enzyme

分类号:

R541.4

DOI:

-

文献标识码:

A

摘要:

目的:探讨七氟醚对未成熟心肌保护及清除氧自由基（OFRS）作用。方法： 择期行先天性心脏病患儿手术60例，年龄2~9岁，ASA II或III级, 随机分为七氟醚组(30例)，和异丙酚组(30例)，麻醉诱导时，七氟醚组吸入氧5~6 L/min+40~60 ml/L七氟醚,异丙酚组异丙酚1~2 mg/kg。两组均采用咪达唑仑0.05~0.1 mg/kg，维库溴铵0.1 mg/kg，舒芬太尼1 μg/kg诱导。麻醉维持七氟醚组吸入4 ml/L~8 ml/L的七氟醚，异丙酚组异丙酚1~3 mg/(kg·h)。两组麻醉维持用维库溴铵0.1 mg/kg，每小时追加1次，舒芬太尼30 μg~40 μg/kg。分别于麻醉诱导前（T0）、体外循环开始前（T1）、体外循环开始后（T2），手术结束即刻（T3）,从桡动脉抽取桡动脉血2 ml，取血浆测定丙二醛(MDA)含量及超氧化物歧化酶(SOD)的活性。结果： 与异丙酚组比较MDA及SOD，T0、T1无显著变化，T2和T3时七氟醚组SOD显著升高（P<0.05）MDA显著降低（P<0.05）。结论： 七氟醚对未成熟心肌保护作用优于异丙酚，其机制与清除OFRS减少氧化应激等有关。

Abstract:

AIM:To investigate the effects of sevoflurane on immature myocardial protection and scavenging of oxygen free radicals (OFRS). METHODS: Sixty patients undergoing surgery for congenital heart diseases (ages 2 to 9 years; ASA grade II or III) were randomly divided into sevoflurane group (sev group, n=30) and propofol group (pro group, n=30) during induction of anesthesia. Sev group inhaled oxygen for 5-6 L/min+40-60 ml/L sevoflurane and pro group for propofol 1-2 mg/kg. Both groups were given midazolam 0.05-0.1 mg/kg, vecuronium 0.1 mg/kg, and sufentanil 1 μg/kg. In sev group, anesthesia was maintained with inhalation of sevoflurane, 4-8 ml/L, and in pro group with propofol 1-3 mg/(kg·h). Anesthesia in both groups was maintained with vecuronium 0.1 mg/(kg·h) and sufentanil 30-40 μg/kg. Before induction of anesthesia (T0), at the beginning of cardiopulmonary bypass (T1) and at the end of cardiopulmonary bypass (T2), and at the end of operation (T3), plasma malondialdehyde (MDA) and superoxide dismutase enzyme (SOD) from blood were detected. RESULTS: No obvious difference in MDA and SOD was observed between groups at T0 and T1 (P>0.05), but in sev group, SOD was significantly higher and MDA was significantly lower at T2 and T3 (both P<0.05). CONCLUSION: Sevoflurane is superior to propofol in protection of immature myocardia, possibly via reduced reaction of the oxidative stress by scavenging oxygen free radicals.

参考文献/References

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备注/Memo

备注/Memo:

收稿日期：2014-03-19.
通讯作者：郭宙平，主任医师，主要从事心血管麻醉研究Email:gzhouping@sina.com
作者简介：蒋海斌，副主任医师,硕士Email：lzjianghaibin@hotmail.com

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更新日期/Last Update: 2015-01-20