Article: Large-dose propofol during cardiopulmonary bypass decreases biochemical markers of myocardial injury in coronary surgery patients: A comparison with isoflurane

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TitleLarge-dose propofol during cardiopulmonary bypass decreases biochemical markers of myocardial injury in coronary surgery patients: A comparison with isoflurane
AuthorsXia, Z1 3
Huang, Z1 2
Ansley, DM3
Issue Date2006
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.anesthesia-analgesia.org
CitationAnesthesia And Analgesia, 2006, v. 103 n. 3, p. 527-532 [How to Cite?]
DOI: http://dx.doi.org/10.1213/01.ane.0000230612.29452.a6
AbstractWe investigated if increasing propofol's dosage to augment its antioxidant capacity during cardiopulmonary bypass (CPB) could confer cardiac protection. Fifty-four coronary artery bypass graft surgery patients were randomly assigned to small-dose propofol (Group P; n = 18), large-dose propofol (Group HiP; n = 18), or isoflurane Group (Group I; n = 18). After the induction, anesthesia was maintained with an inspired concentration of isoflurane 1%-3.5% (Group I) or a continuous infusion of propofol 60 μg·kg·min (Group P) throughout the surgery. In Group HiP, this dose of propofol was increased to 120 μg·kg·min for 10 min before the onset of CPB until 15 min after aortic unclamping and then decreased to 60 μg·kg·min until the end of surgery. The duration of aortic cross-clamping was 83 ± 24, 88 ± 22, and 81 ± 20 min in Group P, Group HiP, and Group I, respectively (P > 0.1). Plasma malondialdehyde, a marker of oxidative stress, was significantly lower at 8 h after CPB, and Troponin I was lower at 24 h after CPB in Group HiP compared with Group P and Group I (P < 0.05). There was a significant reduction in inotropic requirements for separation from CPB in Group HiP compared with Group I. Postoperative systemic vascular resistance was significantly reduced in Group HiP as compared with Group I. Mean cardiac index was significantly higher at 24 h after CPB in Group HiP compared with Group P and Group I (P < 0.05) (Group I, 2.2 ± 0.1; Group P, 2.3 ± 0.2; and Group HiP, 2.8 ± 0.3 L • min·m, respectively). The duration of intensive care unit stay was significantly shorter in Group Hi-P compared with Group I. We conclude that administration of a large dose of propofol during CPB attenuates postoperative myocardial cellular damage as compared with isoflurane or small-dose propofol anesthesia. © 2006 by International Anesthesia Research Society.
ISSN0003-2999
2011 Impact Factor: 3.286
2011 SCImago Journal Rankings: 0.184
DOIhttp://dx.doi.org/10.1213/01.ane.0000230612.29452.a6
ISI Accession Number IDWOS:000240049800002
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorXia, Z
dc.contributor.authorHuang, Z
dc.contributor.authorAnsley, DM
dc.date.accessioned2012-05-29T06:00:57Z
dc.date.available2012-05-29T06:00:57Z
dc.date.issued2006
dc.description.abstractWe investigated if increasing propofol's dosage to augment its antioxidant capacity during cardiopulmonary bypass (CPB) could confer cardiac protection. Fifty-four coronary artery bypass graft surgery patients were randomly assigned to small-dose propofol (Group P; n = 18), large-dose propofol (Group HiP; n = 18), or isoflurane Group (Group I; n = 18). After the induction, anesthesia was maintained with an inspired concentration of isoflurane 1%-3.5% (Group I) or a continuous infusion of propofol 60 μg·kg·min (Group P) throughout the surgery. In Group HiP, this dose of propofol was increased to 120 μg·kg·min for 10 min before the onset of CPB until 15 min after aortic unclamping and then decreased to 60 μg·kg·min until the end of surgery. The duration of aortic cross-clamping was 83 ± 24, 88 ± 22, and 81 ± 20 min in Group P, Group HiP, and Group I, respectively (P > 0.1). Plasma malondialdehyde, a marker of oxidative stress, was significantly lower at 8 h after CPB, and Troponin I was lower at 24 h after CPB in Group HiP compared with Group P and Group I (P < 0.05). There was a significant reduction in inotropic requirements for separation from CPB in Group HiP compared with Group I. Postoperative systemic vascular resistance was significantly reduced in Group HiP as compared with Group I. Mean cardiac index was significantly higher at 24 h after CPB in Group HiP compared with Group P and Group I (P < 0.05) (Group I, 2.2 ± 0.1; Group P, 2.3 ± 0.2; and Group HiP, 2.8 ± 0.3 L • min·m, respectively). The duration of intensive care unit stay was significantly shorter in Group Hi-P compared with Group I. We conclude that administration of a large dose of propofol during CPB attenuates postoperative myocardial cellular damage as compared with isoflurane or small-dose propofol anesthesia. © 2006 by International Anesthesia Research Society.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationAnesthesia And Analgesia, 2006, v. 103 n. 3, p. 527-532 [How to Cite?]
DOI: http://dx.doi.org/10.1213/01.ane.0000230612.29452.a6
dc.identifier.doihttp://dx.doi.org/10.1213/01.ane.0000230612.29452.a6
dc.identifier.epage532
dc.identifier.isiWOS:000240049800002
dc.identifier.issn0003-2999
2011 Impact Factor: 3.286
2011 SCImago Journal Rankings: 0.184
dc.identifier.issue3
dc.identifier.scopuseid_2-s2.0-33749041982
dc.identifier.spage527
dc.identifier.urihttp://hdl.handle.net/10722/147236
dc.identifier.volume103
dc.languageeng
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.anesthesia-analgesia.org
dc.publisher.placeUnited States
dc.relation.ispartofAnesthesia and Analgesia
dc.relation.referencesReferences in Scopus
dc.titleLarge-dose propofol during cardiopulmonary bypass decreases biochemical markers of myocardial injury in coronary surgery patients: A comparison with isoflurane
dc.typeArticle
Author Affiliations
  1. Wuhan University
  2. Shenzhen Sun Yat-Sen Cardiovascular Hospital
  3. The University of British Columbia