【罂粟摘要】丙泊酚和七氟烷对紫绀型先天性心脏病患儿的抗炎和抗氧化作用

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丙泊酚和七氟烷对紫绀型先天性心脏病患儿的抗炎和抗氧化作用

贵州医科大学    麻醉与心脏电生理课题组

翻译：文春雷

编辑：宋雨婷

审校：曹莹

目的

本试验旨在比较丙泊酚和七氟烷对紫绀型先天性心脏病（CCHD）患儿的抗炎和抗氧化作用。

试验设计

本试验为一项单中心、前瞻性、随机、双盲研究。  

受试对象

1-10岁接受择期心脏手术的CCHD患儿。

干预措施

全麻患儿随机接受七氟烷（S组）或丙泊酚（P组）。在手术结束时和术后第6、12和24小时评估全身炎症反应综合征（SIRS）的发生情况。麻醉诱导后（T0）、放开主动脉夹闭时（T1）、手术结束时（T2）、术后24小时（T3）进行采血。分析血清中白细胞介素6和肿瘤坏死因子的水平，以及总抗氧化状态（TAS）和总氧化状态。

结果

SIRS在S组中均高于P组（P = 0.020，P = 0.036，P = 0.004，P = 0.008）。两组间的平均肿瘤坏死因子和白细胞介素6水平均无显著差异。P组T2时的TAS水平高于S组（P = 0.036）。P组T2时血清TAS水平较T0时升高，而S组T2时TAS水平下降（P = 0.041）。

结论

结果显示，丙泊酚对接受心脏手术的CCHD患儿具有更大的抗氧化作用，并在降低SIRS方面优于七氟烷。

原始文献来源：  

Feride Karacaer, Ebru Biricik, Murat Ilgınel,et al.The Anti-Inflammatory and Antioxidant Effects of Propofol and Sevoflurane in Children With Cyanotic Congenital Heart Disease.[J]. Journal of Cardiothoracic and Vascular Anesthesia,2022:1-8.

英文原文

The Anti-Inflammatory and Antioxidant Effects of Propofol and Sevoflurane in Children With Cyanotic Congenital Heart Disease

Objective: The authors aimed to compare the anti-inflammatory and antioxidant effects of propofol and sevoflurane in children with cyanotic congenital heart disease (CCHD) undergoing cardiac surgery with cardiopulmonary bypass.

Design: Prospective, randomized, double-blind study.

Setting: Single center, university hospital.

Participants: Children ages 1-10 years with CCHD undergoing elective cardiac surgery with cardiopulmonary bypass.

Interventions: Children were randomized to receive general anesthesia with either sevoflurane (group S) or propofol (group P). Systemic inflammatory response syndrome (SIRS) occurrence was assessed at the end of the surgery and at the sixth, 12th, and 24th postoperative hours. Blood samples were obtained at 4 times: after anesthesia induction (T0), after release of the aortic cross-clamp (T1), at the end of the surgery (T2), and at the postoperative 24th hour (T3). The serum levels of interleukin 6 and tumor necrosis factor alpha, and the total antioxidant status (TAS) and total oxidant status, were analyzed.

Results: SIRS was more common in group S than in group P at all times (p = 0.020, p = 0.036, p = 0.004, p = 0.008). There were no significant differences between the groups in the mean tumor necrosis factor alpha and interleukin 6 levels at any time. The TAS level at T2 was higher in group P than group S (p = 0.036). The serum TAS level increased at T2 compared with T0 in group P, but it decreased in group S (p = 0.041).

Conclusion: The results showed that propofol provided a greater antioxidant effect and reduced SIRS postoperatively more than sevoflurane in children with CCHD undergoing cardiac surgery.

-End-

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