Abstract
Introduction. This article contains a review of the most significant research papers on cardioprotection effect anesthetic preconditioning
in pediatric congenital heart disease (CHD) corrective surgery with cardiopulmonary bypass (CPB).
Objective. To evaluate cardioprotective effects of Sevoflurane in pediatric atrial septal defect (ASD) corrective surgery with CPB.
Material and Methods. The presented monocentric, prospective, randomized cohort research focused on 58 children, average
12±7.5 months. Their average weight was 9±2.88 kg. The patients were randomized into two groups. Group One included those
who had been administered inhalation anesthesia (IA) (n=31) induced with midazolam 0.2–0.4 mg/kg, fentanyl 5 mcg/kg, rocuronium
0.9 mg/kg, and maintained through inhalation of sevoflurane in 2–2.5 vol.%, and infusion of fentanyl at 5 mcg/kg/hr and
rocuronium at 0.6 mg/kg/hr. Group Two included those who had been administered total intravenous anesthesia (TIVA) (n=27)
induced with propofol in 2–4 mg/kg, and maintained with propofol at 5–12 mg/kg/hr. Narcotic analgesics and muscle relaxant drugs
were administered in same dosage as in Group One.
Results. All children aged under 36 months, who underwent ASD corrective surgery with CPB, and sevofluran administered in all
stages of anesthesia, showed a less manifested rise of troponin I concentration in T6 point. However, in a span of 24 hours the difference
in troponin I concentration increases to statistically significant level. Dosage of cardiotonic support drugs is considerably
lower in Group One, compared to the TIVA group. There is also statistically significant difference in the length of artificial respiration
period in the case of inhalation anesthesia with the use of sevofluran. To confirm the obtained results the study needs to be carried
on, including an increased number of patients.
Conclusion. The study has shown that in the post-surgical period children who underwent ASD corrective surgery with the use of
sevofluran, show lower levels of troponin I during the first 24 hours after the surgery.
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About the authors
- Ol’ga A. Stepanicheva, Anesthesiologist-Intensivist, orcid.org/0000-0002-3157-8660;
-
Mikhail M. Rybka, Dr Med. Sc., Head of Department, orcid.org/0000-0001-8206-8794;
-
Dzhumber Ya. Khinchagov, Cand. Med. Sc., Anesthesiologist-Intensivist, orcid.org/0000-0002-4161-7416;
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Dmitriy V. Zotov, Anesthesiologist-Intensivist, orcid.org/0000-0003-4297-0809;
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Koba V. Mumladze, Anesthesiologist-Intensivist, orcid.org/0000-0003-4725-6890;
-
Anna S. Loseva, Anesthesiologist-Intensivist, orcid.org/0000-0003-4037-2653;
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Ekaterina A. Rogal’skaya, Cand. Med. Sc., Doctor of Clinical Laboratory Diagnostics, orcid.org/0000-0003-3327-1723;
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Maksim V. Lomakin, Anesthesiologist-Intensivist, orcid.org/0000-0003-1019-6310
