Effects of sevoflurane and propofol on extubation time,waking time,myocardial enzymes and prognosis in patients undergoing mechanical ventilation in intensive care unit
Li Jingjing
Zhang Yan
Gao Rongting
Abstract：Objective To explore the effects of sevoflurane and propofol on extubation time,waking time, myocardial enzymes and prognosis in critical patients undergoing mechanical ventilation. Methods Sixty-six critical patients undergoing mechanical ventilation in intensive care unit of Zhoushan Hospital,Zhejiang Province were enrolled from June 2016 to December 2017. According to different sedatives,they were randomly divided into sevoflurane group(33 cases) and propofol group(33 cases). Vital signs,extubation time and waking time were recorded. Levels of cardiac troponin I(cTnI) and creatine kinase isozyme(CK-MB) were detected before and 12,24,48 h after sedation. Adverse reactions and cardiovascular events were observed during sedation. Results There was no significant difference of systolic blood pressure(SBP) ,diastolic blood pressure(DBP) ,heart rate(HR) and respiratory rate(RR) between groups before sedation(all P > 0.05). After sedation,SBP,DBP,HR and RR significantly decreased in both groups and they were significantly lower in sevoflurane group than those in propofol group[(128 ± 5) mmHg vs (136 ± 5) mmHg,(72 ± 6) mmHg vs (78 ± 5) mmHg,(86 ± 10) times /min vs (92 ± 10) times /min,(15 ± 5) times /min vs (18 ± 5) times /min](all P < 0.05). Extubation time and waking time in sevoflurane group were significantly shorter than those in propofol group[(15 ± 10) min vs (99 ± 32) min,(36 ± 13) min vs (163 ± 122) min](both P < 0.001). There was no significant difference of cTnI and CK-MB levels between groups before sedation(both P > 0.05). After sedation,levels of cTnI and CK-MB significantly decreased in both groups; cTnI and CK-MB levels 12,24,48 h after sedation in sevoflurane group were significantly lower than those in propofol group(all P < 0.05). Incidence of adverse reactions in sevoflurane group was significantly lower than that in propofol group[6.1％ (2 /33) vs 30.3％ (10 /33) ](P = 0.025). The 30 d incidence of cardiovascular events in sevoflurane group was significantly lower than that in propofol group [9.1％ (3 /33) vs 27.3％(9 /33) ](P = 0.035). Conclusion Compared with propofol,sevoflurane shows better sedative effect, earlier extubation and waking,better protective effect on myocardium and less cardiovascular events.
Keywords：Mechanical ventilationSevofluranePropofolCardiac troponin ICreatine kinase isoenzyme
Publication Date：2019-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 677-681 )