关键词: 冠心病, 七氟醚, 丙泊酚, 瑞芬太尼, 不良反应

Abstract: Objective To investigate the effect of anesthesia with remifentanil combined with sevoflurane versus propofol in patients with coronary heart disease undergoing non-cardiac surgery. Method A total of 80 patients with coronary heart disease who were admitted to our hospital from June 2022 to June 2024 and underwent non-cardiac surgery were enrolled and divided into observation group and control group using a random number table, with 40 patients in each group. The patients in the control group received anesthesia with propofol and remifentanil, and those in the observation group received anesthesia with sevoflurane and remifentanil. The two groups were compared in terms of surgical conditions, vital signs, myocardial injury markers, cardiovascular events, and adverse events. Results Compared with the control group, the observation group had a significantly shorter time to awakening (15.33±1.79 min vs 17.89±2.35 min), a significantly shorter extubation time (13.20±1.54 min vs 16.46±2.48 min), and a significantly lower incidence rate of cardiovascular events [5.00% (2/40) vs 20.00% (8/40)]. The observation group had a significantly higher heart rate than the control group at 30 minutes after anesthesia (T1) (76.78±4.49 beats/min vs 65.43±4.15 beats/min) and at the end of surgery (T2) (78.72±5.05 beats/min vs 72.95±4.83 beats/min), and the observation group also had a significantly higher mean arterial pressure than the control group at T1 (88.76±6.42 mmHg vs 78.33±5.26 mmHg) and T2 (89.83±6.78 mmHg vs 85.22±5.97 mmHg). Compared with the control group, the observation group had significantly lower levels of creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) immediately after surgery (CK-MB: 13.22±1.89 U/L vs 16.98±2.45 U/L, P <0.05; cTnI: 0.06±0.02 ng/mL vs 0.10±0.03 ng/mL, P <0.05) and at 12 hours after surgery (CK-MB: 16.45±2.46 U/L vs 19.77±3.52 U/L, P <0.05; cTnI: 0.21±0.03 ng/mL vs 0.32±0.05 ng/mL, P <0.05). There were no significant differences in adverse events between the two groups (P >0.05). Conclusion Sevoflurane combined with remifentanil can effectively maintain the vital signs of patients with coronary heart disease undergoing non-cardiac surgery, protect their cardiomyocytes, reduce the incidence rate of cardiovascular events, and help the patients with regain consciousness quickly, without serious adverse events. Therefore, it has a certain application value and holds promise for clinical application.

Key words: Coronary heart disease, Sevoflurane, Propofol, Remifentanil, Adverse event