BACKGROUND Ciprofol is a novel agent for intravenous general anesthesia.In February 2022,it was approved by the National Medical Products Administration for general anesthesia induction and maintenance.It has the adva...BACKGROUND Ciprofol is a novel agent for intravenous general anesthesia.In February 2022,it was approved by the National Medical Products Administration for general anesthesia induction and maintenance.It has the advantages of fast onset,fast elimination,stable circulation,and few adverse reactions.However,the efficacy and safety of ciprofol in cardiac surgery with cardiopulmonary bypass have not been reported.Here we describe a case where ciprofol was successfully used for anesthesia in cardiac surgery with cardiopulmonary bypass.CASE SUMMARY A 72-year-old man(height 176 cm;weight 70 kg)was diagnosed with coronary atherosclerotic cardiomyopathy requiring coronary artery bypass grafting and left ventricular aneurysmectomy.Ciprofol was administered for induction(0.4 mg/kg)and maintenance(0.6-1.0 mg/kg/h)of general anesthesia.During the entire operation,the bispectral index,hemodynamics,and blood oxygen saturation were maintained at normal levels.The patient recovered well after surgery,with no serious adverse events related to ciprofol.CONCLUSION Ciprofol is safe and effective for anesthesia in cardiac surgery with cardiopulmonary bypass.展开更多
Background:The role of prophylactic levosimendan in coronary surgery has not been established conclusively.Methods:Postoperative outcomes of 139 patients(mean age,68.2±9.6 years)having preoperative left ventricul...Background:The role of prophylactic levosimendan in coronary surgery has not been established conclusively.Methods:Postoperative outcomes of 139 patients(mean age,68.2±9.6 years)having preoperative left ventricular ejection fraction(LVEF)≤40%and undergoing isolated coronary surgery(2013-2017)were reviewed retrospectively.In 42(30.2%)patients(L-group),an intravenous infusion of levosimendan was started 24 hours before operation.The remaining 97(69.8%)patients were the control group(C-group).A comparison between the two groups regarding outcome of surgery was performed also after propensity matching.Results:Although the risk profile in L-patients was higher than in C-patients(median European System for Cardiac Operative Risk Evaluation II,10.5%vs.6.5%,P=0.013)due to higher prevalence of New York Heart Association class III-IV,LVEF≤30%,and preoperative intra-aortic balloon pump,in-hospital mortality was equivalent(4.8%vs.3.1%,P=0.48).However,low cardiac output,multiple blood transfusion,and any major complication early after surgery were more frequent in L-patients.After one-to-one propensity matching,which resulted in 15 pairs with similar baseline characteristics the use of levosimendan was associated with a trend towards an increased blood use(P=0.077),a higher frequency of any major complication(P=0.053),and lower peak serum levels of cardiac troponin I(P=0.088).No intergroup differences concerning mid-term survival or outcomes were found even for matched patients.Conclusions:When compared with traditional inotropes alone,prophylactic use of levosimendan showed clear benefits/drawbacks neither concerning immediate nor mid-term outcomes after coronary surgery.There could be any advantage in terms of myocardial preservation.展开更多
文摘BACKGROUND Ciprofol is a novel agent for intravenous general anesthesia.In February 2022,it was approved by the National Medical Products Administration for general anesthesia induction and maintenance.It has the advantages of fast onset,fast elimination,stable circulation,and few adverse reactions.However,the efficacy and safety of ciprofol in cardiac surgery with cardiopulmonary bypass have not been reported.Here we describe a case where ciprofol was successfully used for anesthesia in cardiac surgery with cardiopulmonary bypass.CASE SUMMARY A 72-year-old man(height 176 cm;weight 70 kg)was diagnosed with coronary atherosclerotic cardiomyopathy requiring coronary artery bypass grafting and left ventricular aneurysmectomy.Ciprofol was administered for induction(0.4 mg/kg)and maintenance(0.6-1.0 mg/kg/h)of general anesthesia.During the entire operation,the bispectral index,hemodynamics,and blood oxygen saturation were maintained at normal levels.The patient recovered well after surgery,with no serious adverse events related to ciprofol.CONCLUSION Ciprofol is safe and effective for anesthesia in cardiac surgery with cardiopulmonary bypass.
文摘Background:The role of prophylactic levosimendan in coronary surgery has not been established conclusively.Methods:Postoperative outcomes of 139 patients(mean age,68.2±9.6 years)having preoperative left ventricular ejection fraction(LVEF)≤40%and undergoing isolated coronary surgery(2013-2017)were reviewed retrospectively.In 42(30.2%)patients(L-group),an intravenous infusion of levosimendan was started 24 hours before operation.The remaining 97(69.8%)patients were the control group(C-group).A comparison between the two groups regarding outcome of surgery was performed also after propensity matching.Results:Although the risk profile in L-patients was higher than in C-patients(median European System for Cardiac Operative Risk Evaluation II,10.5%vs.6.5%,P=0.013)due to higher prevalence of New York Heart Association class III-IV,LVEF≤30%,and preoperative intra-aortic balloon pump,in-hospital mortality was equivalent(4.8%vs.3.1%,P=0.48).However,low cardiac output,multiple blood transfusion,and any major complication early after surgery were more frequent in L-patients.After one-to-one propensity matching,which resulted in 15 pairs with similar baseline characteristics the use of levosimendan was associated with a trend towards an increased blood use(P=0.077),a higher frequency of any major complication(P=0.053),and lower peak serum levels of cardiac troponin I(P=0.088).No intergroup differences concerning mid-term survival or outcomes were found even for matched patients.Conclusions:When compared with traditional inotropes alone,prophylactic use of levosimendan showed clear benefits/drawbacks neither concerning immediate nor mid-term outcomes after coronary surgery.There could be any advantage in terms of myocardial preservation.
