Document Detail


Prolonged sevoflurane administration in the off-pump coronary artery bypass graft surgery: Beneficial effects.
MedLine Citation:
PMID:  23886454     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: The benefits of intraoperative administration of halogenated agents in patients undergoing cardiac surgery have been shown by numerous studies. The mechanisms of preconditioning and postconditioning appear to be the cause of these benefits. The possibility of maintaining the early postoperative sedation with halogenated agents, after its intraoperative administration, can increase their benefits.
PATIENTS AND METHODS: This is a prospective trial with 60 patients undergoing coronary artery bypass graft surgery divided into 3 groups according to the administration of hypnotic drugs in the intraoperative and postoperative periods (sevoflurane, sevoflurane: SS, sevoflurane-propofol: SP, propofol-propofol: PP). For the first 48 hours, hemodynamic parameters, the need for inotropic drugs, N-terminal pro-brain natriuretic peptide, and troponin I plasmatic concentrations were obtained.
RESULTS: There were significant differences between group SS and the other 2 groups in the levels of N-terminal pro-brain natriuretic peptide (SS [501 ± 280 pg/mL] compared with SP [1270 ± 498 pg/mL] and PP [1775 ± 527 pg/mL] [P < .05]) and troponin I (SS [0.5 ± 0.4 ng/mL] compared with SP [1.61 ± 1.30 ng/mL] and PP [2.27 ± 1.5 ng/mL] [P < .05]) and a lower number of inotropic drugs.
CONCLUSION: Sevoflurane administration in patients undergoing off-pump coronary artery bypass graft, in the operating room and the intensive care unit, decreases myocardial injury markers compared with patients who only received sevoflurane in the intraoperative period, but both were a better option to decrease levels of myocardial markers when compared with the propofol group.
Authors:
Jose L Guerrero Orriach; M Galán Ortega; M Ramirez Aliaga; P Iglesias; M Rubio Navarro; J Cruz Mañas
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-7-22
Journal Detail:
Title:  Journal of critical care     Volume:  -     ISSN:  1557-8615     ISO Abbreviation:  J Crit Care     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-7-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013.
Affiliation:
Department of Anaesthesia, Hospital Virgen de la Victoria, Málaga, Spain. Electronic address: guerreroorriach@terra.com.
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