To determine whether the antioxidant and anti-inflammatory properties of propofol confer benefit in adult patients undergoing elective coronary artery bypass grafting. Prospective, blinded, randomized, controlled clinical investigation. Single-center, university teaching hospital and academic research laboratory. Twenty-one adult patients (11 control, 10 intervention) with chronic stable angina and normal ventricular function scheduled to undergo elective coronary artery bypass grafting. All patients received a standardized fentanyl-isoflurane anesthetic. Fifteen minutes before reperfusion, patients in the intervention group received a target-controlled infusion of propofol, continued for 4 hours after cross-clamp release. Patients in the control group received saline administered in a similar fashion. Serum concentration of malondialdehyde (MDA) (from systemic and coronary sinus blood); systemic concentrations of interleukins 4, 6, 8, and 10; and systemic leukocyte functions (respiratory burst, phagocytosis, and β2 integrin expression) were measured up to 36 hours after reperfusion. A high serum malondialdehyde concentration was detected in the coronary sinus in control patients, 10 minutes after reperfusion; serum malondialdehyde was not detected in the coronary sinus at this time in patients who received propofol (41.4 [15.6–1,150] μmol/L v 0, p = 0.004). Interleukin-8 concentrations increased 2 and 4 hours after reperfusion in the control group. Interleukin-6 concentrations were greater in the control group than the propofol group 4 hours after clamp release (289.1 [165.2–561] ρg/mL v 153.2 (58.2–280.3) ρg/mL, respectively, p = 0.003). Mean dose of propofol was 31.7 mg/kg during the study period. Clinically relevant concentrations of propofol may attenuate free radical-mediated and inflammatory components of myocardial reperfusion injury in patients undergoing elective coronary artery bypass graft surgery.
Simvastatin blunts the increase of circulating adhesion molecules after coronary artery bypass surgery with cardiopulmonary bypass
MASTROROBERTO P;
2004-01-01
Abstract
To determine whether the antioxidant and anti-inflammatory properties of propofol confer benefit in adult patients undergoing elective coronary artery bypass grafting. Prospective, blinded, randomized, controlled clinical investigation. Single-center, university teaching hospital and academic research laboratory. Twenty-one adult patients (11 control, 10 intervention) with chronic stable angina and normal ventricular function scheduled to undergo elective coronary artery bypass grafting. All patients received a standardized fentanyl-isoflurane anesthetic. Fifteen minutes before reperfusion, patients in the intervention group received a target-controlled infusion of propofol, continued for 4 hours after cross-clamp release. Patients in the control group received saline administered in a similar fashion. Serum concentration of malondialdehyde (MDA) (from systemic and coronary sinus blood); systemic concentrations of interleukins 4, 6, 8, and 10; and systemic leukocyte functions (respiratory burst, phagocytosis, and β2 integrin expression) were measured up to 36 hours after reperfusion. A high serum malondialdehyde concentration was detected in the coronary sinus in control patients, 10 minutes after reperfusion; serum malondialdehyde was not detected in the coronary sinus at this time in patients who received propofol (41.4 [15.6–1,150] μmol/L v 0, p = 0.004). Interleukin-8 concentrations increased 2 and 4 hours after reperfusion in the control group. Interleukin-6 concentrations were greater in the control group than the propofol group 4 hours after clamp release (289.1 [165.2–561] ρg/mL v 153.2 (58.2–280.3) ρg/mL, respectively, p = 0.003). Mean dose of propofol was 31.7 mg/kg during the study period. Clinically relevant concentrations of propofol may attenuate free radical-mediated and inflammatory components of myocardial reperfusion injury in patients undergoing elective coronary artery bypass graft surgery.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
