Aida Kinderytė, Edmundas Širvinskas, Vilmantė Borutaitė, Andrius Macas
Coronary artery bypass graft (CABG) surgery on cardiopulmonarybypass (CPB) is frequently a useful method in the treatment of progressive coronary insufficiency today. According to the data of literature the most common lethal complications after this type of operations are myocardial infarct and arrhythmias associated with ischemic-reperfusion injury. The aim of this study was to evaluate the influence of volatile anaesthetic sevoflurane on clinical parametersof perioperative period and to compare it with intravenous anaesthetic propofol. A prospective randomized clinical trial has been completed. In this study we have evaluated postoperative clinical parameters: hemodynamic stability, time of mechanical ventilation, stay in the intensive care unit, the amount of lactate in the blood serum. For the assessment of myocardial damage, associated with reperfusion injury, we evaluated the amount of troponin I (TnI). The samples for TnI were made immediately after induction of anaesthesia and 12 hours after the operation. In this study 72 patients undergoing elective first time CABG surgery on CPB were included. In group I, 36 patients undergoing anaesthesia with volatile anaesthetic sevoflurane and in group II, 36 patients undergoing anaesthesia with intravenous anaesthetic propofol. Demographic, surgical and clinical data were similar and without any statistical differences in both groups. In the blood sample 12 hours after the operation in all patients the amount of TnI was elevated and there was a statistically significant difference between the both groups. It was significantly higher in propofol group if compared with sevoflurane group – 3.5 ± 1.1 ng/ml vs. 2.2 ± 0.8 ng/ml (p<0.001). Although major myocardial damage after CABG sygery on CPB was in propofol group patients, it had no influence on clinical parameters.
Keyword(s): volatile anaesthetics, propofol, cardioprotection, ischemic-reperfusion injury.
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