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

Abstract:

OBJECTIVE:To determine whether the antioxidant and anti-inflammatory properties of propofol confer benefit in adult patients undergoing elective coronary artery bypass grafting. DESIGN:Prospective, blinded, randomized, controlled clinical investigation. SETTING:Single-center, university teaching hospital and academic research laboratory. PARTICIPANTS:Twenty-one adult patients (11 control, 10 intervention) with chronic stable angina and normal ventricular function scheduled to undergo elective coronary artery bypass grafting. INTERVENTIONS:All 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. MEASUREMENTS:Serum 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. RESULTS:A 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. CONCLUSION:Clinically 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.

authors

Corcoran TB,Engel A,Sakamoto H,O'Callaghan-Enright S,O'Donnell A,Heffron JA,Shorten G

doi

10.1053/j.jvca.2004.07.018

keywords:

subject

Has Abstract

pub_date

2004-10-01 00:00:00

pages

592-604

issue

5

eissn

1053-0770

issn

1532-8422

pii

S105307700400151X

journal_volume

18

pub_type

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