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

TitleLarge-dose propofol during cardiopulmonary bypass decreases biochemical markers of myocardial injury in coronary surgery patients: A comparison with isoflurane
Authors
Issue Date2006
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.anesthesia-analgesia.org
Citation
Anesthesia And Analgesia, 2006, v. 103 n. 3, p. 527-532 How to Cite?
Abstract
We 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.
Persistent Identifierhttp://hdl.handle.net/10722/147236
ISSN
2013 Impact Factor: 3.422
ISI Accession Number ID
References

 

Author Affiliations
  1. Hubei General Hospital
  2. Wuhan University
  3. Shenzhen Sun Yat-Sen Cardiovascular Hospital
  4. The University of British Columbia
DC FieldValueLanguage
dc.contributor.authorXia, Zen_US
dc.contributor.authorHuang, Zen_US
dc.contributor.authorAnsley, DMen_US
dc.date.accessioned2012-05-29T06:00:57Z-
dc.date.available2012-05-29T06:00:57Z-
dc.date.issued2006en_US
dc.identifier.citationAnesthesia And Analgesia, 2006, v. 103 n. 3, p. 527-532en_US
dc.identifier.issn0003-2999en_US
dc.identifier.urihttp://hdl.handle.net/10722/147236-
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.en_US
dc.languageengen_US
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.anesthesia-analgesia.orgen_US
dc.relation.ispartofAnesthesia and Analgesiaen_US
dc.titleLarge-dose propofol during cardiopulmonary bypass decreases biochemical markers of myocardial injury in coronary surgery patients: A comparison with isofluraneen_US
dc.typeArticleen_US
dc.identifier.emailXia, Z:zyxia@hkucc.hku.hken_US
dc.identifier.authorityXia, Z=rp00532en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1213/01.ane.0000230612.29452.a6en_US
dc.identifier.pmid16931656-
dc.identifier.scopuseid_2-s2.0-33749041982en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33749041982&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume103en_US
dc.identifier.issue3en_US
dc.identifier.spage527en_US
dc.identifier.epage532en_US
dc.identifier.isiWOS:000240049800002-
dc.publisher.placeUnited Statesen_US
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