Effects of Shenmai injection on the values of CO, SV, and EF in patients undergoing off-pump coronary artery bypass graft: A randomized, clinical trial.

BACKGROUND: To explore the effects of Shenmai (SM) injection on the values of cardiac output (CO), stroke volume (SV), and the ejection fraction (EF) in patients treated with off-pump coronary artery bypass graft (OPCABG). METHODS: Forty patients undergoing OPCABG were randomly divided into SM group (n = 20) and the 5% glucose (G) group (n = 20). The control liquids were injected from the beginning of the operation to the start of coronary artery bypass graft (CABG). The values of CO, SV, and EF before induction (t1), at the beginning of operation (t2), 30 minutes after the start of operation (t3), at the beginning of coronary artery bypass graft (t4), at the end of coronary artery bypass graft (CABG) (t5), and at the end of operation (t6) were recorded. RESULTS: The values of CO, SV, and EF in the patients of SM group at t3 to t6 were found to be significantly higher than those at t1 (P < .05). The values of CO, SV, and EF in the patients of G group were found to be increased at t5 and t6 (P < .05). At t3 and t4, the values of CO, SV, and EF in SM group were significantly higher than those in the G group (P < .05). CONCLUSION: In patients with OPCABG, the infusion of SM injection can effectively increase the values of CO, SV, and EF and increase the safety of anesthesia management.

Relationship between post-operative cognitive dysfunction and regional cerebral oxygen saturation and ß-amyloid protein.

OBJECTIVE: To investigate the relationship between post-operative cognitive dysfunction (POCD) and regional cerebral oxygen saturation (rSO2) and ß-amyloid protein (Aß) in patients undergoing laparoscopic pancreaticoduodenectomy. METHODS: Fifty patients undergoing elective laparoscopic pancreaticoduodenectomy received five groups of neuropsychological tests 1 d pre-operatively and 7 d post-operatively, with continuous monitoring of rSO2 intra-operatively. Before anesthesia induction (t0), at the beginning of laparoscopy (t1), and at the time of pneumoperitoneum 120 min (t2), pneumoperitoneum 240 min (t3), pneumoperitoneum 480 min (t4), the end of pneumoperitoneum (t5), and 24 h after surgery, jugular venous blood was drawn respectively for the measurement of Aß by enzyme-linked immunosorbent assay (ELISA). RESULTS: Twenty-one cases of the fifty patients suffered from POCD after operation. We found that the maximum percentage drop in rSO2 (rSO(2, %max)) was significantly higher in the POCD group than in the non-POCD group. The rSO(2, %max) value of over 10.2% might be a potential predictor of neurocognitive injury for those patients. In the POCD group, the plasma Aß levels after 24 h were significantly higher than those of pre-operative values (P<0.01). After 24 h, levels of plasma Aß in the POCD group were significantly higher than those in the non-POCD group (P<0.01). CONCLUSIONS: The development of POCD in patients undergoing laparoscopic pancreaticoduodenectomy is associated with alterations of rSO2 and Aß. Monitoring of rSO2 might be useful in the prediction of POCD, and Aß might be used as a sensitive biochemical marker to predict the occurrence of POCD.