Comparing the Hemodynamic Changes during and after Coronary Artery Bypass Graft Surgery under General Anesthesia with Propofol and Isoflurane

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Hemodynamic changes during and after coronary artery bypass graft surgery and the effects of these changes on postoperative complications are important. As there was not any study to compare the effects of propofol and isoflurane on hemodynamic changes during and after coronary artery bypass grafting, we decided to do this.Methods: This clinical trial study was done on 80 patients undergoing coronary artery bypass surgery at the ages of 40 to 70 years in 2014 in Chamran Hospital, Isfahan, Iran. The subjects received isoflurane or propofol in two groups. Hemodynamic changes during coronary artery bypass graft surgery and then every 30 minutes until the end of the surgery and in intensive care unit every two hours to eight hours were compared.Findings: Based on the repeated measure ANOVA test, the differences between the two groups in systolic blood pressure (P = 0.475), diastolic blood pressure (P = 0.885), heart rate (P = 0.130), pulse pressure (P = 0.572) and arterial oxygen saturation (P = 0.425) in 10 times of measuring (before the pumping starts, at pumping, 30, 60, 90 and 120 minutes later, immediately after the pumping and 2, 6 and 8 hours after admission to the intensive care unit) were not significant.Conclusion: In our study, isoflurane and propofol did not cause significant differences in the hemodynamic variables before, during and after coronary artery bypass graft surgery.

Keywords


  1. Kabukcu HK, Sahin N, Temel Y, Titiz TA. Hemodynamics in coronary artery bypass surgery: effects of intraoperative dexmedetomidine administration. Anaesthesist 2011; 60(5): 427-31.
  2. Yusuf S, Zucker D, Peduzzi P, Fisher LD, Takaro T, Kennedy JW, et al. Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration. Lancet 1994; 344(8922): 563-70.
  3. Bignami E, Biondi-Zoccai G, Landoni G, Fochi O, Testa V, Sheiban I, et al. Volatile anesthetics reduce mortality in cardiac surgery. J Cardiothorac Vasc Anesth 2009; 23(5): 594-9.
  4. Huiku M, Uutela K, van Gils M, Korhonen I, Kymalainen M, Merilainen P, et al. Assessment of surgical stress during general anaesthesia. Br J Anaesth 2007; 98(4): 447-55.
  5. Oztekin I, Gokdogan S, Oztekin DS, Issever H, Goksel O, Canik S. Effects of propofol and midazolam on lipids, glucose, and plasma osmolality during and in the early postoperative period following coronary artery bypass graft surgery: a randomized trial. Yakugaku Zasshi 2007; 127(1): 173-82.
  6. Yao YT, Li LH. Sevoflurane versus propofol for myocardial protection in patients undergoing coronary artery bypass grafting surgery: a meta-analysis of randomized controlled trials. Chin Med Sci J 2009; 24(3): 133-41.
  7. Desborough JP. The stress response to trauma and surgery. Br J Anaesth 2000; 85(1): 109-17.
  8. Aronson S, Fontes ML, Miao Y, Mangano DT. Risk index for perioperative renal dysfunction/failure: critical dependence on pulse pressure hypertension. Circulation 2007; 115(6): 733-42.
  9. Fontes ML, Aronson S, Mathew JP, Miao Y, Drenger B, Barash PG, et al. Pulse pressure and risk of adverse outcome in coronary bypass surgery. Anesth Analg 2008; 107(4): 1122-9.
  10. Bucerius J, Gummert JF, Borger MA, Walther T, Doll N, Falk V, et al. Predictors of delirium after cardiac surgery delirium: effect of beating-heart (off-pump) surgery. J Thorac Cardiovasc Surg 2004; 127(1): 57-64.
  11. Reich DL, Bodian CA, Krol M, Kuroda M, Osinski T, Thys DM. Intraoperative hemodynamic predictors of mortality, stroke, and myocardial infarction after coronary artery bypass surgery. Anesth Analg 1999; 89(4): 814-22.
  12. Baumert JH, Hein M, Hecker KE, Satlow S, Neef P, Rossaint R. Xenon or propofol anaesthesia for patients at cardiovascular risk in non-cardiac surgery. Br J Anaesth 2008; 100(5): 605-11.
  13. Jakobsen CJ, Berg H, Hindsholm KB, Faddy N, Sloth E. The influence of propofol versus sevoflurane anesthesia on outcome in 10,535 cardiac surgical procedures. J Cardiothorac Vasc Anesth 2007; 21(5): 664-71.
  14. Gold JP, Charlson ME, Williams-Russo P, Szatrowski TP, Peterson JC, Pirraglia PA, et al. Improvement of outcomes after coronary artery bypass. A randomized trial comparing intraoperative high versus low mean arterial pressure. J Thorac Cardiovasc Surg 1995; 110(5): 1302-11.