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From the *Anesthesiology Research Laboratory, Department of Anesthesiology, Renmin Hospital of Wuhan University; Shenzhen Sun Yat-sen Cardiovascular Hospital, China; and Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, Canada.
Address correspondence and reprint requests to Zhengyuan Xia, MD, PhD, Anesthesiology Research Laboratory, Department of Anesthesiology, Renmin Hospital, Wuhan University, 238 Jiefang Rd., Wuhan, 430060, P. R. China or Faculty of Pharmaceutical Sciences, The University of British Columbia, 2146 East Mall, Vancouver, BC, V6T 1Z3, Canada. Address e-mail to zhengyuan_xia{at}yahoo.com.
We investigated if increasing propofol's dosage to augment its antioxidant capacity during cardiopulmonary bypass (CPB) could confer cardiac protection. Fifty-four coronary artery bypass graft surgery patients were randomly assigned to small-dose propofol (Group P; n = 18), large-dose propofol (Group HiP; n = 18), or isoflurane Group (Group I; n = 18). After the induction, anesthesia was maintained with an inspired concentration of isoflurane 1%–3.5% (Group I) or a continuous infusion of propofol 60 µg · kg–1 · min–1 (Group P) throughout the surgery. In Group HiP, this dose of propofol was increased to 120 µg · kg–1 · min–1 for 10 min before the onset of CPB until 15 min after aortic unclamping and then decreased to 60 µg · kg–1 · min–1 until the end of surgery. The duration of aortic cross-clamping was 83 ± 24, 88 ± 22, and 81 ± 20 min in Group P, Group HiP, and Group I, respectively (P > 0.1). Plasma malondialdehyde, a marker of oxidative stress, was significantly lower at 8 h after CPB, and Troponin I was lower at 24 h after CPB in Group HiP compared with Group P and Group I (P < 0.05). There was a significant reduction in inotropic requirements for separation from CPB in Group HiP compared with Group I. Postoperative systemic vascular resistance was significantly reduced in Group HiP as compared with Group I. Mean cardiac index was significantly higher at 24 h after CPB in Group HiP compared with Group P and Group I (P < 0.05) (Group I, 2.2 ± 0.1; Group P, 2.3 ± 0.2; and Group HiP, 2.8 ± 0.3 L · min–1 · m–2, respectively). The duration of intensive care unit stay was significantly shorter in Group Hi-P compared with Group I. We conclude that administration of a large dose of propofol during CPB attenuates postoperative myocardial cellular damage as compared with isoflurane or small-dose propofol anesthesia.
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  B. Wang, T. Luo, D. Chen, and D. M. Ansley Propofol Reduces Apoptosis and Up-Regulates Endothelial Nitric Oxide Synthase Protein Expression in Hydrogen Peroxide-Stimulated Human Umbilical Vein Endothelial Cells Anesth. Analg., October 1, 2007; 105(4): 1027 - 1033. [Abstract] [Full Text] [PDF]
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 K.-X. Liu, T. Rinne, W. He, F. Wang, and Z. Xia Propofol attenuates intestinal mucosa injury induced by intestinal ischemia-reperfusion in the rat: [Le propofol attenue les lesions de la muqueuse intestinale provoquees par l'ischemie-reperfusion intestinale chez le rat] Can J Anesth, May 1, 2007; 54(5): 366 - 374. [Abstract] [Full Text] [PDF]
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Z. Xia, H.-m. Liu, and Q.-z. Tang Does propofol suppress nitrosative stress during aortic surgery in pigs? Can J Anesth, December 1, 2006; 53(12): 1267 - 1268. [Full Text] [PDF]
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