Comparison of sevoflurane and propofol anaesthetic regimes in respect to the release of troponin I and cystatin C in off-pump myocardial revascularisation: a randomised controlled trial
1University Medical Centre Ljubljana, Ljubljana, Slovenia
2University Rehabilitation Institute, Ljubljana, Slovenia
3University of Ljubljana, Faculty of Economics, Ljubljana, Slovenia
DOI: 10.22514/SV121.102016.6 Vol.12,Issue S1,October 2016 pp.36-42
Published: 10 October 2016
Objective. Sevoflurane has been used in cardiac surgery because of its protective ef-fects on the myocardium from ischaemic injury. We wanted to test the hypothesis that sevoflurane has beneficial effects on the heart and kidneys in comparison to propofol.
Methods. We conducted a randomised controlled study, with balanced randomi-zation blocked by sex. The participants were 62 patients undergoing off-pump myocardial revascularization (44 men and 18 women), who did not have a myocardi-al infarction less than 24 hours before the start of the operation and who had normal serum values of troponin I preoperatively. The surgery and the measurements were conducted according to the same protocol for both groups. Propofol was used for the induction of anaesthesia in both groups; anaesthesia was continued with either propofol or sevoflurane. Troponin I and cystatin C plasma concentrations were de-termined in eight consecutive blood sam-ples, starting before induction of anaesthe-sia and ending 48 hours after admission to the intensive care unit (ICU). The data were log-transformed and analysed using analysis of variance.
Results. We observed a clear and highly statistically significant effect of time for troponin I (p<0.001) without statistically significant differences between the groups (either main or interaction effects). For the majority of patients, the measurements rose quickly upon reperfusion and reached a peak 12 hours after admission to the ICU, descending approximately back to the rep-erfusion level 48 hours after admission to the ICU. Similar inferences were reached for cystatin C, for which the time-course was approximately bath-shaped.
Conclusion. We observed no clear superi-ority of either sevoflurane or propofol an-aesthetic regime in off-pump myocardial revascularisation.
anaesthetic regime, cardiopro-tection, kidney function, heart surgery
NINA KOSMAČ,GAJ VIDMAR,MARTIN VIRAG,JOŠKO OSREDKAR,IVAN KNEŽEVIĆ. Comparison of sevoflurane and propofol anaesthetic regimes in respect to the release of troponin I and cystatin C in off-pump myocardial revascularisation: a randomised controlled trial. Signa Vitae. 2016. 12(S1);36-42.
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