Objective To investigate the relationship between anesthetic factors and intestinal injury in the patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB). Methods Ninety American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes, aged 18-64 yr, with New York Heart Association grade Ⅱ or Ⅲ, undergoing elective cardiac surgery with CPB, were divided into 2 groups(n=45 each) using a random number table: propofol-based anesthesia group (group P) and sevoflurane-based anesthesia group (group S). CPB was established routinely after anesthesia induction.Before induction (T0), immediately after aortic unclamping (T1), at 30 min after aortic unclamping (T2) and at 2 h after discontinuation of CPB (T3), blood samples were collected from the radial artery for determination of the plasma endotoxin, D-lactic acid, diamine oxidase (DAO) and intestinal fatty acid-binding protein (I-FABP) concentrations (by enzyme-linked immunosorbent assay) and plasma interleukin-6 (IL-6), IL-8 and tumor necrosis factor-alpha (TNF-α) concentrations (using radio-immunity method). Results Compared with the baseline at T0, the concentrations of plasma endotoxin, D-lactic acid, DAO, TNF-α, IL-6, IL-8 and I-FABP were significantly increased at T1-T3 in both groups (P<0.05). Compared with group P, the concentrations of plasma endotoxin, D-lactic acid, DAO, TNF-α, IL-6, IL-8 and I-FABP were significantly decreased at T1-T3 in group S(P<0.05). Conclusion Anesthetic factors are related to intestinal injury in patients undergoing cardiac surgery with CPB.Compared with propofol-based anesthesia, sevoflurane-based anesthesia is helpful in reducing the inflammatory response and in decreasing the degree of intestinal injury and is more suitable for the cardiac surgery with CPB. Key words: Anesthesia, general; Propofol; Cardiopulmonary bypass; Intestinal mucosa; Wounds and injuries; Sevoflurane