Objective To evaluate the effect of pressure-controlled ventilation-volume guaranteed(PCV-VG)on the perioperative pulmonary oxygenation function of the patients undergoing off-pump coronary artery bypass grafting(OPCABG).Methods Forty patients aged 40-65 years,of both sexes,with the American Society of Anesthesiologists physical status Ⅲ or Ⅳ,preoperative cardiac function(NYHA)class Ⅱ or Ⅲ,scheduled for elective OPCABG were assigned via the random number table method into two groups(n=20):a volume-controlled ventilation(VCV)group(Group V)and a PCV-VG group(Group P).Other respiratory parameters of the anesthesia machine were set consistently in both groups.At the time of sawing the sternum(T0),when left internal mammary artery harvesting with the operating table tilted 10° to the left(T1),when left anterior descending coronary artery bypass grafting with the operating table tilted 10° to the right(T2),when right coronary artery bypass grafting with the operating table in a 30° head-down and tilted 10° to the right(T3),when circumflex coronary artery bypass grafting with the operating table in a 20° head-down and tilted 15° to the right(T4),and at the end of the surgery(T5),the peak airway pressure(Ppeak),mean airway pressure(Pmean),plateau airway pressure(Pplat),and pulmonary dynamic compliance(Cdyn)were recorded.The alveolar-arterial partial pressure difference of oxygen(PA-aDO2),oxygenation index(OI),and respiratory index(RI)were recorded at the aforementioned time points as well as on postoperative day 1(T6),day 3(T7),and day 7(T8).The dosages of intraoperative drugs(sufentanil,remifentanil,and rocuronium bromide),postoperative endotracheal tube indwelling time,the stay time in the cardiac surgery intensive care unit,and the occurrence of pulmonary complications within 7 days after the surgery were also recorded.Results Compared with Group V,Group P showed significant downward trends in Ppeak,Pmean,and Pplat during T3-T5,as well as in PA-aDO2 and RI during T3-T8(all P<0.05).Meanwhile,Group P exhibited significant upward trends in Cdyn during T3-T5 and in OI during T3-T8(all P <0.05).Compared with those in Group V,the postoperative endotracheal tube indwelling time and the stay time in the cardiac surgery intensive care unit were shortened in Group P(all P<0.05).There was no statistically significant difference in dosages of intraoperative drugs(sufentanil,remifentanil,and rocuronium bromide)or incidence of pulmonary complications within 7 days after the surgery between the two groups of patients(all P>0.05).Conclusion Compared with VCV,PCV-VG can improve the perioperative pulmonary oxygenation function of the patients undergoing OPCABG.
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