Effect of Fentanyl Combined with Etomidate on Hemodynamics,Myocardial Injury and Inflammation Reaction in Patients Undergoing Heart Valve Replacement under Cardiopulmonary Bypass
Objective:To investigate the effects of Fentanyl combined with Etomidate on hemodynamics,myocardial injury and inflammation reaction in patients undergoing heart valve replacement under cardiopulmonary bypass(CPB).Method:Seventy patients with cardiac valve replacement under CPB admitted to the First Affiliated Hospital of Xiamen University from August 2022 to July 2023 were retrospectively selected.They were divided into reference group(n=35)and study group(n=35)according to different anesthesia induction schemes.The control group was given Fentanyl,and the study group was given Fentanyl combined with Etomidate.The hemodynamics,myocardial injury indexes and inflammatory factors of the two groups were compared before anesthesia induction(t0),after CPB initiation(t1),when CPB was stopped(t2)and after surgery(t3).Result:At t1-t3,the heart rate and mean arterial pressure in the study group were higher than those in the reference group,and the differences were statistically significant(P<0.05).At t1-t3,creatine the kinase isoenzyme-MB(CK-MB)and cardiac troponin I(cTnI)levels in the study group were lower than those in the reference group,and the differences were statistically significant(P<0.05).At t1-t3,the level of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the study group were lower than those in the reference group,and the differences were statistically significant(P<0.05).Conclusion:Fentanyl combined with Etomidate can improve the inflammatory state of body in CPB heart valve replacement,stabilize the hemodynamic,protect myocardial function,and accelerate the prognosis and rehabilitation of patients.
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