Effects of sevoflurane on regional cerebral oxygen saturation and postoperative cognitive function in patients undergoing cardiac valve replacement
ZHAO Yamei1, SHI Hong-wei1, GE Ya-li1, WEI Hai-yan1, WANG Zhen-hong1, TAO Hong-wei1, XIAO Li-qiong2
(1. Department of Anesthesiology, Affiliated Nanjing Hospital of Nanjing Medical University, Nanjing Jiangsu 210006; 2. Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Jiangsu 210006， China)
Abstract：Objective： To observe the effects of sevoflurane inhalation during cardiopulmonary bypass(CPB) on regional cerebral oxygen saturation(rSO2) and postoperative cognitive function in patients undergoing single valve replacement. Methods： Fortytwo patients scheduled for single valve replacement under CPB, were randomly divided into 3 groups(n=14 each). During CPB, the anesthesia was maintained with propofol 4～6 mg·kg-1·h-1 continuous infusion in the control group; the anesthesia was maintained with propofol 2～3 mg·kg-1·h-1 continuous infusion,and with 0.5 minimum alveolar concentration(MAC） sevoflurane inhalation via the membrane oxygenator in the combination group; the anesthesia was maintained with 1～1.5 MAC sevoflurane inhalation via the membrane oxygenator in the sevoflurane group. rSO2 was recorded before anesthesia induction(T1), 5 min after clamping the aorta(T2), 30 min after the beginning of CPB(T3), 30 min after the termination of CPB(T4). The cognitive function was evaluated by neuropsychological tests at 1 day before surgery and 7 day after surgery. Extubation time and ICU staying length were also recorded. Results： Compared with control group, rSO2 was significantly increased at T3，T4 in both combination group and sevoflurane group(P<0.05). There was no statistical significance in the incidence of postoperative cognitive dysfunction and extubation time and ICU staying length between the three groups(P>0.05). Conclusion： Sevoflurane inhalation during CPB can increase rSO2, but it has no significant impact on the incidence of postoperative cognitive dysfunction.
［Key words］sevoflurane; cardiac valve replacement; cardiopulmonary bypass; postoperative cognitive dysfunction; regional cerebral oxygen saturation
收稿日期: 2016-09-27
通讯作者:
史宏伟（通讯作者），主任医师，E-mail：mdshw@163.com
作者简介: 赵雅梅（1984—），女，江苏南京人，医师，硕士
引用本文:
赵雅梅1, 史宏伟1, 葛亚力1, 魏海燕1, 王振红1, 陶红伟1, 肖立琼2. 七氟醚对心脏瓣膜置换术患者rSO2和术后认知功能的影响[J]. 江苏大学学报:医学版, 2016, 26(06): 515-.
ZHAO Ya-Mei-1, Shi-Hong-Wei-1, Ge-Ya-Li-1, Wei-Hai-Yan-1, Wang-Zhen-Hong-1, Tao-Hong-Wei-1, Xiao-Li-Qiong-2. Effects of sevoflurane on regional cerebral oxygen saturation and postoperative cognitive function in patients undergoing cardiac valve replacement. Journal of Jiangsu University(Medicine Edition), 2016, 26(06): 515-.
2016, Vol. 26 
