Study on stress response and wake quality in patients of off-pump coronary artery bypass grafting under different anesthesia methods

  AIM   AIM To investigate the effects of intravenous anesthesia and different concentrations of sevoflurane on stress response and wake quality in patients with off-pump coronary artery bypass surgery.

  METHODS   Ninety patients aged 56 to 73 years under off-pump coronary artery bypass grafting surgery were randomly divided into sufentanil+propofol group (Group A), sufentanil+propofol+0.5 MAC sevoflurane group (Group B) and sufentanil and propofol+1.0 MAC sevoflurane group (Group C), with 30 cases in each group. Cortisol, epinephrine, norepinephrine, blood glucose, HR, MAP, duration of surgery, postoperative wake time, ICU time and hospitalization days were recorded at different time points in each group. The incidence of postoperative malignant vomiting and agitation during the waking period were also compared.

  RESULTS   Cortisol, epinephrine, norepinephrine and blood glucose at T2, T3 in Group A were significantly higher than those in Group B and Group C (P<0.05), while there was no statistically difference between Group B and Group C. In Group B, MAP was significantly higher at postoperative (P<0.05) and HR significantly was lower (P<0.05). Waking time and ICU time in Group B were the shortest (P<0.05). In Group A, the incidence of nausea and vomiting was higher, while that of agitation was the lowest.

  CONCLUSION   Anesthesia with sevoflurane can reduce the patient's stress response. Additionally, the hemodynamics of 0.5 MAC sevoflurane were more stable and ICU time was shorter, but the incidence of agitation was still high.