Comparison of TIVA and Desflurane Added to a Subanaesthetic Dose of Propofol in Patients Undergoing Coronary Artery Bypass Surgery: Evaluation of Haemodynamic and Stress Hormone Changes

• Published in: BioMed research international 2016-01, Vol.2016 (2016), p.1-6
• Main Authors: Çoban, Abdulkadir, Yazıcı Ersoy, Çiğdem, Turkmen, Kultigin, Günay, Murat, Aksüt, Mehmet, Onk, Oruç Alper, Akarsu Ayazoğlu, Tülin, Onk, Didem, Özensoy, Aynur
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Anesthesia; Anesthesia, Intravenous; Anesthesiology; Anesthetics, Inhalation - administration & dosage; Aorta - drug effects; Biomarkers; Body Mass Index; Cardiopulmonary Bypass; Coronary Artery Bypass; Coronary vessels; Diabetes; Drug dosages; Fentanyl - administration & dosage; Heart attacks; Heart surgery; Hemodynamics; Hormones - blood; Hospitals; Humans; Internal medicine; Isoflurane - analogs & derivatives; Isoflurane - therapeutic use; Laboratories; Middle Aged; Mortality; Myocardial Ischemia - surgery; Propofol - administration & dosage; Propofol - therapeutic use; Stress response; Studies; Surgical outcomes; Trauma; Veins & arteries
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2016/3272530

Introduction. Increased levels of stress hormones are associated with mortality in patients undergoing coronary artery bypass grafting (CABG). Aim. To compare total intravenous anaesthesia (TIVA) and desflurane added to a subanaesthetic dose of propofol. Material and Methods. Fifty patients were enrolled in this study. Fentanyl (3–5 mcg/kg/h) was started in both groups. Patients were divided into two groups. The PD group ( n = 2 5 ) received 1 minimum alveolar concentration (MAC) desflurane anaesthesia in addition to propofol infusion (2-3 mg/kg/h), while P group ( n = 2 5 ) received propofol infusion (5-6 mg/kg/h) only. Biochemical data, cortisol, and insulin levels were measured preoperatively (T0), after initiation of CPB but before cross-clamping the aorta (T1), after removal of the cross-clamp (T2), and at the 24th postoperative hour (T3). Results. Systolic, diastolic, and mean arterial pressure levels were significantly higher in PD group than those in P group in T1 and T2 measurements ( p ≤ 0.05 ). CK-MB showed a significant decrease in group P ( p ≤ 0.05 ). When we compared both groups, cortisol levels were significantly higher in PD group than P group ( p ≤ 0.05 ). Conclusion. Stress and haemodynamic responses were better controlled using TIVA than desflurane inhalation added to a subanaesthetic dose of propofol in patients undergoing CABG.