EFFECT OF PROPOFOL IN CARDIOPLEGIA SOLUTION ON BIOMARKERS OF MYOCARDIAL INJURY IN CORONARY ARTERY BYPASS GRAFTING SURGERY: A RANDOMIZED DOUBLE-BLIND CLINICAL TRIAL

Received 2020-02-03; Accepted 2020-09-14; Published 2021-02-18

Authors

  • Reza Jouybar Anesthesiology and Critical Care Research Center, Shiraz University of Medical Science, Shiraz, Iran.
  • GholamAli Heidari Anesthesiology and Critical Care Research Center, Shiraz University of Medical Science, Shiraz, Iran.
  • Reza Khajeh Anesthesiology and Critical Care Research Center, Shiraz University of Medical Science, Shiraz, Iran.
  • Hojatollah Najafi Health Human Resources Research Center, Department of Health in Disasters and Emergencies, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Elham Asadpour Anesthesiology and Critical Care Research Center, Shiraz University of Medical Science, Shiraz, Iran.
  • Zahra Esmaeilinezhad Anesthesiology and Critical Care Research Center, Shiraz University of Medical Science, Shiraz, Iran.

DOI:

https://doi.org/10.22452/jummec.vol24no1.5

Keywords:

Coronary Artery Bypass Graft surgery, Cardioplegic Solution, Cardiac Protection, Propofol

Abstract

Introduction: Coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) triggers an inflammatory reaction, leading to the development of myocardial damage and dysfunction. It is assumed that propofol, a general anesthetic agent, has a protective role against oxidative stress. The aim of this study was to evaluate the effect of propofol on myocardial protection when added to cardioplegic solution in patients undergoing CABG.

Methods: In this prospective and double-blind RCT study, 120 patients undergoing CABG surgery were randomly assigned into two equal groups. In one group, we added 1200 µg/min (ultimate dose 4 µg/ml) propofol to cardioplegic solution and in the control group, an equal volume of normal saline was added to cardioplegic solution. Serum levels of CPK-MB and Troponin I were checked at four time points, including: just after induction (T1) as baseline, after chest closure (T2), 6 hours after arrival to ICU (T3) and 24 hours after ICU admission (T4).

Results: Cardiac enzyme levels had significant increase over time in both groups (p-value <0.05). It was observed that the enzyme levels in the propofol group increased less compared with the control group; however, this difference was not significant. Both groups were also similar in incidence of post-operative arrhythmia and need for use of IABP.

Conclusion: Adding a dose of 1200 µg/min (ultimate dose 4 µg/mL) propofol to cardioplegia solution does not have an effect on CPK-MB & troponin I level.

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Published

2021-02-18

Issue

Section

Research article