Cardioprotective efficacy of sevoflurane vs. propofol during induction and/or maintenance in patients undergoing coronary artery revascularization surgery without pump: A randomized trial
| Autor: | A. Florez Vela, C. Santiago Fernandez, M. Rubio Navarro, A. Ramirez Fernandez, J. Cruz Mañas, J.J. Escalona Belmonte, M. Galán Ortega, D. Ariza Villanueva, J. Alcaide Torres, J.L. Guerrero Orriach, M. Ramirez Aliaga, M.I. Moreno Cortes, E. Matute Gonzalez, L. Garrido Sanchez, E. Alsina Marcos |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Methyl Ethers medicine.medical_specialty Cardiotonic Agents Urinary system Sedation Hemodynamics Coronary Artery Disease 030204 cardiovascular system & hematology Sevoflurane 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Internal medicine Troponin I Myocardial Revascularization Humans Medicine Propofol Aged Revascularization surgery business.industry Middle Aged Cardiac surgery Treatment Outcome Anesthesia Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Anesthetics Intravenous Platelet Aggregation Inhibitors medicine.drug |
| Zdroj: | International Journal of Cardiology. 243:73-80 |
| ISSN: | 0167-5273 |
| Popis: | Purpose Pre and post-operative administration of sevoflurane in myocardial revascularization surgery provides enhanced cardioprotective effects exerted by pharmacologic pre- and post-conditioning, as compared to propofol. The identification of the enzymes involved in conditioning mechanisms is crucial to the understanding of the effects of sevoflurane in cardiac surgery patients. The impact of sevoflurane on another crucial target organ—the kidney—was also assessed. Methods Ninety patients undergoing off-pump myocardial revascularization surgery were allocated to receive either intra- and postoperative sevoflurane (SS), intraoperative sevoflurane and postoperative propofol (SP), or intra- and postoperative propofol (PP)). Troponin I and hemodynamic parameters were monitored during the first 48 postoperative hours; blood and urine samples were collected at baseline and at 24h to determine Akt, ERK1/2, PKG, iNO, bradykinin receptor, caspase 3, NT proBNP and urinary NGAL. Results The enzymes were overexpressed in the SS group, remained unchanged in the SP group, and decreased in the PP group. Renal function was best preserved in the SS group. Conclusions The overexpression of enzymes induced by intraoperative anesthesia and postoperative sedation with sevoflurane reduces myocardial damage and improves renal function in patients undergoing off-pump myocardial revascularization surgery. |
| Databáze: | OpenAIRE |
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