Background： Myocardial infarction is an important cause of mortality after carotid endarterectomy （CEA）. Sevoflurane provides myocardial protection to patients undergoing coronary surgery, but whether it also reduc...Background： Myocardial infarction is an important cause of mortality after carotid endarterectomy （CEA）. Sevoflurane provides myocardial protection to patients undergoing coronary surgery, but whether it also reduces the incidence of myocardial injury in CEA patients is unclear. In this study, we evaluated the cardioprotective effect of low-dose sevoflurane with propofol in patients undergoing CEA. Methods： This was a single-center, prospective, randomized study conducted between November 2011 and December 2013. The study population of 122 patients who underwent CEA were randomly assigned to two groups. Group A （n = 62） received propofol for anesthetic maintenance, and Group B （n = 60） additionally received 0.8% end-tidal sevoflurane. The bispectral index was kept at 40-60. Myocardial injury, defined as cardiac troponin 1 （cTnl） levels 〉0.04 ng/ml, was the primary end-point. Levels ofcTnl were measured before anesthesia, and at 4, 24, and 7211 after surgery. Perioperative hemodynamic parameters and adverse cardiovascular events after surgery were also recorded. Results： Myocardial injury was detected in 18 patients in Group A and 7 in Group B. The difference was statistically signifcant （29.0% vs. 11.7%, P= 0.018）. The hemodynamic parameters were comparable between the groups, as were adverse cardiovascular events （P = 0.619）. Conclusions： Low-dose sevoflurane inhalation along with propofol reduces the incidence of myocardial injury in symptomatic patients after CEA.展开更多
文摘Background： Myocardial infarction is an important cause of mortality after carotid endarterectomy （CEA）. Sevoflurane provides myocardial protection to patients undergoing coronary surgery, but whether it also reduces the incidence of myocardial injury in CEA patients is unclear. In this study, we evaluated the cardioprotective effect of low-dose sevoflurane with propofol in patients undergoing CEA. Methods： This was a single-center, prospective, randomized study conducted between November 2011 and December 2013. The study population of 122 patients who underwent CEA were randomly assigned to two groups. Group A （n = 62） received propofol for anesthetic maintenance, and Group B （n = 60） additionally received 0.8% end-tidal sevoflurane. The bispectral index was kept at 40-60. Myocardial injury, defined as cardiac troponin 1 （cTnl） levels 〉0.04 ng/ml, was the primary end-point. Levels ofcTnl were measured before anesthesia, and at 4, 24, and 7211 after surgery. Perioperative hemodynamic parameters and adverse cardiovascular events after surgery were also recorded. Results： Myocardial injury was detected in 18 patients in Group A and 7 in Group B. The difference was statistically signifcant （29.0% vs. 11.7%, P= 0.018）. The hemodynamic parameters were comparable between the groups, as were adverse cardiovascular events （P = 0.619）. Conclusions： Low-dose sevoflurane inhalation along with propofol reduces the incidence of myocardial injury in symptomatic patients after CEA.
