Abstract:Objective To investigate the anesthetic efficacy and myocardial protective benefits of sevoflurane in combination with trace amount of opioid during fast-track cardiac surgical procedures. Methods A retrospective analysis was conducted on 89 patients at First People’s Hospital of Kashgar between March 2021 and March 2023. According to the anesthesia methods, they were divided into a control group (n=45) and an observation group (n=44). In the observation group, sevoflurane combined with trace amount of opioid was used for general anesthesia, and anesthesia induction was achieved through sequential administration of midazolam, etomidate, rocuronium, and sevoflurane, followed by maintenance with adjusted sevoflurane concentrations combined with remifentanil pumping. The control group was given total intravenous anesthesia, induced anesthesia with midazolam, etomidate, rocuronium, and fentanyl, and maintained with pump injection of propofol and fentanyl. The following indexes were observed and recorded, including mean arterial pressure (MAP), heart rate (HR) and fluctuation before and after anesthesia (the fluctuation value was defined as the absolute value of the difference between the highest value of the stimulation timepoint and the baseline value after anesthesia), the time of awakening and tracheal extubation, agitation score, cardiac troponin I (cTnI) level and the incidence of postoperative cardiac adverse events in the two groups. Results The HR and MAP were significantly decreased in both groups after anesthesia (P＜0.05), but the fluctuation values of MAP (during skin cutting, sternal sawing, cardiopulmonary bypass rewarming) and the fluctuation values of HR (duringtracheal intubation, surgical operation, and cardiopulmonary bypass rewarming) in the observation group were significantly lower in the observation group than those in the control group (P＜0.01). Compared with the control group, the time of awakening and tracheal extubation were significantly earlier [ ( 35.74±7.64) min vs (50.62±10.29) min, t= 7.732, P＜0.01; (60.29±4.95) min vs (105.78±6.29) min, t= 37.839, P＜0.01], and the postoperative restlessness score was significantly lower (P＜0.05) in the observation group. The levels of cTnI in the observation group at 6 h and 24 h after surgery were significantly lower than those in the control group (P＜0.01), and the incidences of postoperative cardiac ischemia and arrhythmia were lower compared to the control group (6.82% vs 22.22%, 25.00% vs 55.56%, P＜0.05). There was no significant difference in the incidence of myocardial infarction between the two groups ( P> 0.05). Conclusion Sevoflurane combined with trace amount of opioid demonstrates a favorable anesthetic efficacy and myocardial protection in fast-track anesthesia for cardiac surgery.