Objective To investigate the effects of inhaled sevoflurane combined with a therapeutic communication system model on myocardial injury and hemodynamics in patients undergoing heart valve replacement(HVR).Methods A total of 202 patients with HVR admitted to The First Affiliated Hospital with Nanjing Medical University from June 2021 to October 2022 were included and randomly divided into the control group and the experimental group,with 101 patients in each group.Both groups underwent HVR.The control group was given propofol lactic injection to maintain anesthesia during the operation,while the experimental group was given sevoflurane for anesthesia maintenance by inhalation on the basis of propofol lactic injection.Both groups were followed up for three months after the operation,and were given interventions under the model of therapeutic communication system in the perioperative period.Hemodynamics[detected before induction of anesthesia(T1),at 5 min of induction of anesthesia(T2),and at the time of tracheal intubation(T3)],left ventricular function[detected preoperatively(T0),and at 3 months postoperatively(T7)],myocardial injury,brain injury[detected at T1,6 h after aortic opening(T4),and 24 h after aortic opening(T5)],quality of life[detected at T0,1 month postoperatively(T6),and T7],in-hospital outcomes and complications(perioperative period)were compared.Results Compared with those at T1,heart rate(HR)and mean arterial pressure(MAP)at T2 and T3 gradually decreased in both groups,and were lower in the experimental group than those in the control group at the same time points(P＜0.05).Compared with those at T0,left ventricular ejection fraction(LVEF)at T7 was higher while left ventricular end-diastolic volume(LVEDV)and left ventricular end-systolic volume(LVESV)were lower in both groups(P＜0.05).Compared with those at T1,serum cardiac troponin I(cTnI)and creatine kinase isoenzyme(CK-MB)at T4 and T5 gradually increased in both groups,and were lower in the experimental group than those in the control group at the same time points(P＜0.05);plasma neuron-specific enolase(NSE)and Tau protein levels increased in both groups,and were lower in the experimental group than those in the control group at the same time points(P＜0.05).And compared with those at T4,plasma NSE and Tau protein levels at T5 decreased in both groups,and were lower in the experimental group than those in the control group(P＜0.05).Compared with those at T0,the quality of life scores of both groups at T6 and T7 gradually increased,and were higher in the experimental group than those in the control group at the same time points(P＜0.05).There was no statistically significant difference in in-hospital outcomes and complications between the two groups(P＞0.05).Conclusion Inhaled sevoflurane in combination with a therapeutic communication system model significantly improves hemodynamics and reduces myocardial and cerebral injury in patients undergoing HVR,thereby improving quality of life with favorable in-hospital outcomes and safety.
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