Effect of Sevoflurane Combined with Dexmedetomidine on Stress,Circulatory System and Myocardial Injury Markers in Patients with T2DM Undergoing Heart Valve Replacement Under General Anesthesia
Objective To investigate the effect of sevoflurane combined with dexmedetomidine on stress,circulatory system and myocardial injury markers in patients with type 2 diabetes mellitus(T2DM)undergoing heart valve replacement under general anesthesia.Methods A prospective randomized controlled study was conducted.A total of 60 patients with T2DM who underwent heart valve replacement at the the First Affiliated Hospital of Henan University from March 2022 to March 2023 were selected.They were randomly divided into treatment group and control group by the envelope method,with 30 patients in each group.The treatment group was given continuous infusion of dexmedetomidine at 0.5 μg·kg-1·h-1 at the beginning of operation till the end of operation,and was treated with 2％volume fraction sevoflurane for 15 minutes by cardiopulmonary bypass(CPB)machine when the aorta was open.The control group was injected with equal volume of 9 g·L-1 sodium chloride injection,and given the same sevoflurane anesthesia.Perioperative indicators,stress response indicators,hemodynamic indicators,and myocardial injury markers were compared between the two groups.Results There was no statistically difference between the two groups in terms of CPB time,operation time,insulin use,and intraoperative average blood glucose level(P＞0.05).After operation,the levels of blood glucose(Glu),cortisol(Cor)and epinephrine(E)in the treatment group were significantly lower than those in the control group(P＜0.05).There were statistically differences in heart rate(HR)and mean arterial pressure(MAP)in terms of time effect,inter-group effect and interaction effect(P＜0.05).After operation,the levels of troponin Ⅰ(cTnⅠ),creatine kinase(CK)and creatine kinase isozyme(CK-MB)in the treatment group were significantly lower than those in the control group(P＜0.05).Conclusion Applying sevoflurane combined with dexmedetomidine anesthesia to patients with T2DM undergoing heart valve replacement can effectively reduce stress response and myocardial injury,and maintain hemodynamic stability.
万方数据
维普
