The comparison of application effect of sevoflurane and propofol anesthesia methods in the surgery of the heart valve replacement

Objective To compare the application effects of whole sevoflurane inhaling and target-controlled infusion of propofol during the induction period of anesthesia and perioperation.Methods Thirty adult patients undergoing heart valve replacement surgery with cardiopulmonary bypass were divided into intervention group(sevoflurane group,S group) and control group(propofol group,P group) by computer generated random number.The S group received 1% sevoflurane during the anesthetic induction period and sevoflurane concentration in vaporizer increased 1% per minute until reach 3%.The P group received target-controlled infusion of propofol during anesthetic induction.The initial target plasma concentration was 0.8μg / ml,and the concentration increased 0.5μg / ml every minute until intubation.At the same time,all the patients received fentanyl 5μg / kg and rocuronium 0.6 mg / kg.The parameters such as systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR) and BIS value were recorded before anesthetic induction(T0),induction 1 minute(T1),induction 2 minutes(T2),induction 3 minutes(T3),induction 5 minutes(T4),intubation(T5),3 minutes after intubation(T6) and 10 minutes after intubation(T7).Blood glucose levels at T2,T3 and T7 were also measured.Results There were no statistical differences on SBP,DBP,HR and blood glucose during anesthetic induction period.However,SBP decreased significantly on T1-T7 compared to T0(P 0.05) and more significant on T3-T7(P 0.01) in both groups.DBP and HR also decreased significantly during T3-T7 compared to T0(P 0.05),but the blood glucose had no significant change.Conclusions The use of gradient method sevoflurane inhaling and target-controlled infusion of propofol during anesthetic induction for adult heart valve replacement surgery had a certain influence on the hemodynamics but clinically accepted,which could decrease intubation stress response.