Cerebral protective effect of propofol versus sevoflurane combined with sufentanil anesthesia in patients undergoing valvular surgery under cardiopulmonary bypass

Abstract

Objective To compare the cerebral protective effect of propofol and sevoflurane combined with sufentanil anesthesia in the patients undergoing valvular surgery under cardiopulmonary bypass(CPB). Methods Sixty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients, aged 60-70 yr, scheduled for elective valvular surgery under CPB, were randomly divided into either propofol-based anesthesia group(group PA)or sevoflurane-based anesthesia group(group SA), with 30 patients in each group.From induction of anesthesia to the end of surgery, group P received target-controlled infusion of propofol 0.5-2.0 μg/ml, and group S continuously inhaled 0.5%-2.5% sevoflurane.Bispectral index value was maintained at 45-55.Immediately after induction(T0), at the end of surgery(T1), and at 6, 12 and 24 h after surgery(T2-4), the superior vena cava was retrogradely cannulated for blood sampling, and the concentrations of plasma S-100β protein and neuron-specific enzyme were determined using enzyme-linked immunosorbent assay. Results Compared with group SA, the plasma S-100β concentrations at T1, 2 and neuron-specific enzyme concentrations at T1-3 were significantly decreased in group PA. Conclusion The cerebral protective effect of propofol combined with sufentanil anesthesia is superior to that of sevoflurane combined with sufentanil anesthesia in the patients undergoing valvular surgery under CPB. Key words: Propofol; Sufentanil; Anesthetics, inhalation; Cardiopulmonary bypass; Brain injuries