Objective To study the effect of inhalation anaesthetics on myocardial protection during coronary artery bypass grafting (CABG). Methods Data were obtained from searches of Medline and CNKI as well as references listed. It was undertook that only randomized controlled trials (RCTs) evaluating inhalaton anesthetics and intravenous anesthetic drugs or inhalation anesthetics preconditioning during CABG were included. Data were abstracted on cardiac index, inotropic support, and the peak value of troponin I(cTnI) during postoperative period of 24 hours. The weighted mean difference (WMD) with 95% confidence intervals (CI) for continuous data and odds ratio (OR) with 95% CI for dichotomous data were calculated. Statistical analysis was performed using RevMan 4.2.10. Results A total of 1398 cases in 23 trials were accordant with the conditions of analysis. There were significantly higher cardiac index [WMD, 0.41,95% CI(0.17,0.64)], lower serum concentrations of cTnI [WMD,-1.61,95%CI(-2.25,-0.96)]as well as less requirement for inotropic support[OR,0. 45, 95%CI(0.35,0.58)]in the patients randomized to receive inhalation anesthetics compared with those to receive intravenous anaesthetics. Conclusion It is found that inhalation anesthetics provide myocardial protection in CABG surgery.%目的 评价吸入麻醉药对冠状动脉搭桥术(CABG)心肌缺血-再灌注损伤的保护作用.方法 检索Medline和中国期刊全文数据库,收集各研究中的心脏指数、使用正性肌力药的例数和术后24 h内心肌肌钙蛋白I(cTnI)的最高数值.计数资料采用优势比(OR)和95%可信区间(CI)表示.计量资料用加权平均差(WMD)和95%可信区间表示,统计分析用Revman 4.2.10软件完成.结果 符合标准的文献共23篇,1398例患者.分析显示,吸入麻醉约都能使CABG患者术后的心脏指数增加[WMD=0.41;95%CI(0.17,0.64)],使cTnI明显降低[WMD=-1.61;95%CI(-2.25,-0.96)],需用正性肌力药的患者数减少[OR=0.45;95%CI(0.35,0.58)].结论 七氟醚等吸入麻醉药用于CABG具有明显的心肌保护作用.
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