Effects of sevoflurane intravenous-inhalation combined anesthesia on anesthesia quality,cardiac function and cardiovascular events of elderly patients with coronary heart disease undergoing laparoscopic surgery
Objective To explore the influence of sevoflurane intravenous-inhalation combined anesthesia on anesthesia quality,cardiac function and cardiovascular events among elderly patients with coronary heart dis-ease undergoing laparoscopic surgery.Methods A retrospective analysis was conducted on the clinical data of patients with coronary heart disease who received laparoscopic surgery admitted to Taizhou Hospital of Zhejiang Province from July 2020 to August 2023.Forty patients who adopted propofol anesthesia were randomly selected and included in the control group,and 40 patients who received sevoflurane intravenous-inhalation combined anesthesia were randomly included in observation group.The anesthesia quality(anesthesia time,anesthesia satis-faction,awakening time,orientation recovery time)of the two groups were compared.The vital signs[heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP)]at different time points[before surgery(T0),at the beginning of surgery(T1),15 min into surgery(T2),after surgery(T3)]were recorded.The caediac function[cardiac output(CO),left ventricular ejection fraction(LVEF),N-terminal pro-brain natriuretic peptide(NT-proB-NP)],myocardial enzymes[aspartate aminotransferase(AST),lactate dehydrogenase[LDH,creatine kinase isoen-zyme(CK-MB)]and oxidative stress[serum norepinephrine(NE),cortisol(Cor),adrenocorticotropic hormone(ACTH)]levels at T0 and T3 were compared.Results The satisfaction score of observation group were higher than those of the control group(P＜0.05),and the anesthesia time,awakening time and orientation recovery time were of the observation group were all lower than those of the control group(P＜0.05).At T0 and T3,there was no significant differences in HR,SBP and DBP levels between the two groups(P＞0.05).However,at T1 and T2,the HR,SBP and DBP levels of the observation group were higher than those of the control group(P＜0.05).At T3,the CO and LVEF levels of both groups were lower than those at T0,and the observation group was higher the control group(P＜0.05).The NT-proBNP,AST,LDH,CK-MB,NE,Cor and ACTH levels of both groups were higher than those at T0,and the observation group were lower than the control group(P＜0.05).The incidence r of adverse car-diovascular events in the observation group was lower than that in the control group(P＞0.05).Conclusion The sevoflurane intravenous-inhalation combined anesthesia has high anesthesia quality in elderly patients with coro-nary heart disease undergoing laparoscopic surgery,which can reduce the damage to cardiac function and does not increase the risk of adverse cardiovascular events.
LaparoscopyCoronary diseaseSevofluraneIntravenous-inhalation combined anesthesiaHeart function
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