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| A Comparative Study of Etomidate and Propofol in Anesthesia for Patients Undergoing Cardiothoracic Surgery |
| WEN Xiao-juan |
| Chinese Medicine Hospital of Baoji, Shaanxi 721000 |
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Abstract 【Objective】To compare the application effects of etomidate and propofol in anesthesia for patients undergoing cardiothoracic surgery. 【Methods】Ninety-two patients who underwent elective intracardiac surgery under extracorporeal circulation i.e. cardiopulmonary bypass (CPB) were randomly divided into group A and group B, with 46 cases in each. Group A was given etomidate anesthesia while group B was given propofol anesthesia. The hemodynamic indexes (SBP, DBP, HR) were measured before anesthesia (T1), 1 minute after induction (T2), 5 minutes after intubation (T3), 1 minute and 5 minutes after incision (T4 and T5), 1 minute and 5 minutes after splitting the sternum (T6 and T7), before CPB (T8), before the CPB aortic block (T9), 5 minutes after the CPB aortic block was released (T10), at anesthetic machine shutdown (T11), at the end of the surgery (T12) and 24 hours after the surgery (T13). Inflammatory factors (TNF-α, IL-6, IL-8, IL-1) and lipid peroxidation indexes (SOD, MDA) of the two groups before induction (t1), after induction (t2), 5 minutes after the aortic block was released (t3), at anesthetic machine shutdown (t4), 4 hours after anesthetic machine shutdown (t5), and 24 hours after surgery (t6) were compared. 【Results】 SBP and DBP of both groups fluctuated significantly at T2, T7, T8, T9,T10 and T11 compared to T1 of the same group (P<0.05). At T2, T7 and T8, the levels of group A were higher than those of group B (P<0.05). HR of the two groups fluctuated significantly at T4, T5, T8, T9, T11 and T12 compared to T1 of the same group (P<0.05), but there was no significant difference between the two groups (P>0.05). TNF-α of the two groups at t4 and t5, IL-6 at t3, t4 and t5, IL-8 at t4, IL-10 at t3 and t4 were higher compared to t1 of the same group (P<0.05), while TNF-α of group A at t4 was higher than that of group B and IL-10 at t3 and t4 were lower than those of group B (P<0.05). In the two groups, SOD at t4 and MDA at t5 were higher than those at t1 (P<0.05), while MDA in group A at t5 was higher than that in group B (P<0.05). 【Conclusion】 Etomidate is more conducive to the maintenance of the stability of hemodynamics in patients undergoing CPB open heart surgery, while propofol can play a role in myocardial protection by reducing inflammation and lipid peroxidation, which is suitable for patients with cardiac function impairment.
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Received: 10 August 2016
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2016, Vol. 33 
