Document Detail


Cardiac protection by volatile anaesthetics: a multicentre randomized controlled study in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass.
MedLine Citation:
PMID:  17156509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: To evaluate the effects of total intravenous anaesthesia vs. volatile anaesthesia on cardiac troponin release in coronary artery bypass grafting with cardiopulmonary bypass, we performed a multicentre randomized controlled study to compare postoperative cardiac troponin release in patients receiving two different anaesthesia plans. METHODS: We randomly assigned 75 patients to propofol (intravenous anaesthetic) and 75 patients to desflurane (volatile anaesthetic) in addition to an opiate-based anaesthesia for coronary artery bypass grafting. Peak postoperative troponin I release was measured as a marker of myocardial necrosis. RESULTS: There was a significant (P < 0.001) difference in the postoperative median (25th-75th percentiles) peak of troponin I in patients receiving propofol 5,5 (2,3-9,5) ng dL(-1) when compared to patients receiving desflurane 2,5 (1,1-5,3) ng dL(-1). The median (interquartile) troponin I area under the curve analysis confirmed the results: 68 (30.5-104.8) vs. 36.3 (17.9-86.6) h ng dL(-1) (P = 0.002). Patients receiving volatile anaesthetics had reduced need for postoperative inotropic support (24/75, 32.0% vs. 31/75, 41.3%, P = 0.04), and tends toward a reduction in number of Q-wave myocardial infarction, time on mechanical ventilation, intensive care unit and overall hospital stay. CONCLUSIONS: Myocardial damage measured by cardiac troponin release could be reduced by volatile anaesthetics in coronary artery bypass surgery.
Authors:
L Tritapepe; G Landoni; F Guarracino; F Pompei; M Crivellari; D Maselli; M De Luca; O Fochi; S D'Avolio; E Bignami; M G Calabrò; A Zangrillo
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial     Date:  2006-12-08
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  24     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-02-14     Completed Date:  2007-06-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  323-31     Citation Subset:  IM    
Affiliation:
Università degli Studi La Sapienza di Roma, Dipartimento di Scienze Anestesiologiche, Medicina Critica e Terapia del Dolore, Pisa, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anesthetics, Inhalation / pharmacology*
Cardiopulmonary Bypass*
Coronary Artery Bypass / methods*
Female
Heart / drug effects,  physiopathology
Humans
Ischemic Preconditioning, Myocardial
Isoflurane / analogs & derivatives*,  pharmacology
Male
Middle Aged
Propofol / pharmacology
Troponin I / blood
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Troponin I; 2078-54-8/Propofol; 26675-46-7/Isoflurane; 57041-67-5/desflurane

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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