title: Effects of Sevoflurane Inhalation During Cardiopulmonary Bypass on Pediatric Patients: A Randomized Controlled Clinical Trial.
abstract: The effects of sevoflurane inhalation during cardiopulmonary bypass (CPB) on postoperative courses and serum cardiac troponin I (cTnI) concentrations in pediatric patients undergoing cardiac surgery have not been extensively investigated. In this single-center, prospective, randomized trial, an anesthetic regimen containing 2% sevoflurane used throughout the CPB process was compared with a total intravenous anesthesia (TIVA) regimen. One hundred and three patients undergoing congenital heart defect repair with CPB were included in this prospective randomized controlled study. They were randomized into two groups: the sevoflurane group, who received 2% sevoflurane during CPB via an oxygenator, and the control group, who received only an oxygen-air mixture. The pre- and intra-operative parameters were comparable between the two groups. There was a slight but significant increase of arterial diastolic pressure in the sevoflurane group immediately after CPB compared with control patients (46.9 ± 9.3 mm Hg vs. 43.6 ± 8.9 mm Hg; p = 0.033). There was no death in either group. The postoperative ventilation time (in mean [95% confidence interval]) was shorter in the sevoflurane group than that in the control group (26.1 [19.2, 33.0] h vs. 37.7 [24.4, 50.9] h; p = 0.014). The postoperative ICU time, hospital days, and serial serum cTnI concentrations were not significantly different between the two groups. Inhalation of 2% sevoflurane during CPB is beneficial to the recovery of pediatric patients undergoing cardiac surgery but has no significant effect on postoperative cTnI release.
authors.affiliation: From the *Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China; †Department of Thoracic & Cardiovascular Surgery, Xi'an Central Hospital, Xi'an, China; ‡Department of Cardiovascular Surgery, Baoji Municipal Central Hospital, Baoji, China; §Department of Cardiovascular Surgery, Shaanxi General Hospital of CAPF, Xi'an, China; and ¶Department of Pediatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
authors.forename: Hong-Yan
authors.initials: HY
authors.lastname: Xiong
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.forename: Duan-Chao
authors.initials: DC
authors.lastname: Shu
authors.forename: Sheng-Li
authors.initials: SL
authors.lastname: Zhang
authors.forename: Xinhong
authors.initials: X
authors.lastname: Qian
authors.forename: Wei-Xun
authors.initials: WX
authors.lastname: Duan
authors.forename: Liang
authors.initials: L
authors.lastname: Cheng
authors.forename: Shi-Qiang
authors.initials: SQ
authors.lastname: Yu
authors.forename: Zhen-Xiao
authors.initials: ZX
authors.lastname: Jin
mesh_terms: D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D002315:Cardiopulmonary Bypass; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology*; D011446:Prospective Studies; D000077149:Sevoflurane; D019210:Troponin I / Q000097:blood
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D019210:Troponin I; D000077149:Sevoflurane