Document Detail


Myocardial injury is decreased by late remote ischaemic preconditioning and aggravated by tramadol in patients undergoing cardiac surgery: a randomised controlled trial.
MedLine Citation:
PMID:  20847065     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to test, whether the late phase of remote ischaemic preconditioning (L-RIPC) improves myocardial protection in coronary artery bypass grafting (CABG) with cold-crystalloid cardioplegia and whether preoperative tramadol modifies myocardial ischaemia-reperfusion injury using the same group of patients in a single-blinded randomized controlled study. One hundred and one adult patients were randomly assigned to either the L-RIPC, control or tramadol group. L-RIPC consisted of three five-minute cycles of upper limb ischaemia and three five-minute pauses using blood pressure cuff inflation 18 hours prior to the operation. Patients in the tramadol group received 200 mg tramadol retard at 19:00 hours, the day before the operation and at 06:00 hours. Serum troponin I levels were measured at eight, 16 and 24 hours after surgery. Myocardial samples for inducible and endothelial nitric oxide synthases (iNOS, eNOS) estimation were drawn twice: before and after cannulation for cardiopulmonary bypass from the auricle of the right atrium. We found that L-RIPC can reduce injury beyond the myocardial protection provided by cold-crystalloid cardioplegia, and tramadol worsened myocardial injury after CABG. Expressions of iNOS were increased in the control (significantly) and L-RIPC groups and dampened in the tramadol group.
Authors:
Robert Wagner; Pavel Piler; Helena Bedanova; Petr Adamek; Lucie Grodecka; Tomas Freiberger
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-09-16
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  11     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-03-10     Revised Date:  2011-10-27    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  758-62     Citation Subset:  IM    
Affiliation:
Department of Cardiac Anaesthesia, Centre for Cardiovascular and Transplant Surgery (CKTCH), St. Anne's University Hospital, Brno, Czech Republic. robert.wagner@cktch.cz
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Analgesics, Opioid / adverse effects*
Biological Markers / blood
Coronary Artery Bypass / adverse effects*
Czech Republic
Female
Heart Arrest, Induced
Heart Diseases / chemically induced,  etiology*,  metabolism,  prevention & control*
Humans
Hypothermia, Induced
Ischemic Preconditioning*
Male
Middle Aged
Myocardium / enzymology
Nitric Oxide Synthase Type II / metabolism
Nitric Oxide Synthase Type III / metabolism
Potassium Compounds / administration & dosage
Single-Blind Method
Time Factors
Tramadol / adverse effects*
Treatment Outcome
Troponin I / blood
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Biological Markers; 0/Potassium Compounds; 0/Troponin I; 0/potassium cardioplegic solution; 27203-92-5/Tramadol; EC 1.14.13.39/NOS2 protein, human; EC 1.14.13.39/NOS3 protein, human; EC 1.14.13.39/Nitric Oxide Synthase Type II; EC 1.14.13.39/Nitric Oxide Synthase Type III

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


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