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Published on: March 27, 2018
Application of different anesthetic methods in coronary artery bypass grafting and the effect on postoperative
1Department of Cardiac Surgery, Jining No. 1 People's Hospital, Jining, Shandong 272000, P.R. China.
Insights
Sevoflurane combined anesthesia improves outcomes for coronary artery bypass grafting patients by reducing oxidative stress and enhancing cognitive function. This method offers a better postoperative recovery compared to traditional fentanyl and propofol anesthesia.
Area of Science:
- Cardiology
- Anesthesiology
- Surgical Outcomes
Background:
- Coronary artery bypass grafting (CABG) necessitates effective anesthetic strategies to optimize patient outcomes.
- Different anesthetic agents may influence perioperative physiological responses and recovery.
- Understanding the impact of anesthetic choices on oxidative stress and cognitive function is crucial for improving surgical care.
Purpose of the Study:
- To compare the effects of sevoflurane combined anesthesia versus fentanyl and propofol anesthesia on perioperative hemodynamics, oxidative stress markers, and postoperative outcomes in CABG patients.
- To evaluate the influence of anesthetic methods on inflammatory responses, recovery times, and cognitive function post-CABG.
Main Methods:
- A randomized controlled trial involving 94 CABG patients, divided into control (fentanyl and propofol) and observation (sevoflurane combined) groups.
- Hemodynamic parameters (HR, MAP, SVRI, CI), beta-endorphin (β-EP), malondialdehyde (MDA), and inflammatory factors (CRP, TNF-α, IL-6) were measured.
- Postoperative recovery metrics (eating time, out of bed time, length of stay) and cognitive function (MoCA, MMSE scales) were assessed.
Main Results:
- Both anesthetic methods maintained hemodynamic stability during CABG.
- Sevoflurane anesthesia led to better adjustment of β-EP levels and reduced oxidative stress (MDA) compared to the control group.
- Patients receiving sevoflurane showed significantly earlier eating and out-of-bed times, shorter hospital stays, and improved cognitive function scores (MoCA, MMSE) on postoperative day one.
Conclusions:
- Sevoflurane combined anesthesia is favorable for postoperative outcomes in CABG patients.
- This anesthetic approach effectively modulates the body's beta-endorphin response and mitigates oxidative stress.
- Sevoflurane anesthesia offers advantages in terms of faster recovery and better cognitive preservation following coronary artery bypass grafting.
Abstract:
Application of different anesthetic methods in coronary artery bypass grafting and its effect on postoperative outcome were explored. Ninety-four patients undergoing coronary artery bypass grafting in Jining No. 1 People's Hospital from March 2017 to February 2018 were randomly divided into the control and observation groups. The control group was anesthetized by fentanyl and propofol. The observation group was anesthetized by sevoflurane combined anesthesia. The mean heart rates (HR), mean arterial pressure (MAP), systemic vascular resistance index (SVRI) and cardiac index (CI) in the two groups were compared. The levels of β endorphin (β-EP) and malondialdehyde (MDA) in patients were examined. Adverse reactions in the two groups were compared. The enzyme-linked immunosorbent assay (ELISA) was used to detect the changes of serum inflammatory factors. The prognosis of the two groups was analyzed and compared. MoCA and MMSE scale were used to evaluate postoperative cognitive function in the two groups. The levels of β-EP and MDA in the two groups during operation were higher than those before operation (P<0.05). On the third, fifth and seventh day after operation, the CRP, TNF-α and IL-6 levels of the two groups increased significantly compared to those before operation (P<0.05). The eating time and out of bed time in the observation group were significantly earlier than those in the control group, and the length of stay in the observation group was significantly shorter than that in the control group (P<0.05). On the first day after operation, the scores of MoCA and MMSE in the observation group were better than those in the control group (P<0.05). The two different anesthetic methods can maintain the perioperative hemodynamic stability of coronary artery bypass patients, but sevoflurane intravenous-inhalation combined anesthesia can effectively adjust the β-EP in the body, and reduce the oxidative stress response, which is favorable for postoperative outcome.
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