• J. Cardiothorac. Vasc. Anesth. · Oct 2004

    Randomized Controlled Trial Clinical Trial

    The effects of propofol on lipid peroxidation and inflammatory response in elective coronary artery bypass grafting.

    • Tomas B Corcoran, Arnth Engel, Hidetoshi Sakamoto, Sheila O'Callaghan-Enright, Aonghus O'Donnell, James A Heffron, and George Shorten.
    • Department of Anaesthesia, University College Cork, Cork City, Republic of, Ireland. mascor@gofree.indigo.ie
    • J. Cardiothorac. Vasc. Anesth. 2004 Oct 1; 18 (5): 592-604.

    ObjectiveTo determine whether the antioxidant and anti-inflammatory properties of propofol confer benefit in adult patients undergoing elective coronary artery bypass grafting.DesignProspective, blinded, randomized, controlled clinical investigation.SettingSingle-center, university teaching hospital and academic research laboratory.ParticipantsTwenty-one adult patients (11 control, 10 intervention) with chronic stable angina and normal ventricular function scheduled to undergo elective coronary artery bypass grafting.InterventionsAll patients received a standardized fentanyl-isoflurane anesthetic. Fifteen minutes before reperfusion, patients in the intervention group received a target-controlled infusion of propofol, continued for 4 hours after cross-clamp release. Patients in the control group received saline administered in a similar fashion.MeasurementsSerum concentration of malondialdehyde (MDA) (from systemic and coronary sinus blood); systemic concentrations of interleukins 4, 6, 8, and 10; and systemic leukocyte functions (respiratory burst, phagocytosis, and beta(2) integrin expression) were measured up to 36 hours after reperfusion.ResultsA high serum malondialdehyde concentration was detected in the coronary sinus in control patients, 10 minutes after reperfusion; serum malondialdehyde was not detected in the coronary sinus at this time in patients who received propofol (41.4 [15.6-1,150] micromol/L v 0, p = 0.004). Interleukin-8 concentrations increased 2 and 4 hours after reperfusion in the control group. Interleukin-6 concentrations were greater in the control group than the propofol group 4 hours after clamp release (289.1 [165.2-561] rhog/mL v 153.2 (58.2-280.3) rhog/mL, respectively, p = 0.003). Mean dose of propofol was 31.7 mg/kg during the study period.ConclusionClinically relevant concentrations of propofol may attenuate free radical-mediated and inflammatory components of myocardial reperfusion injury in patients undergoing elective coronary artery bypass graft surgery.

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