Content area
Full text
Inammation, Vol. 36, No. 6, December 2013 (# 2013) DOI: 10.1007/s10753-013-9671-6
Comparison of the Effects of Desurane and Propofol Anesthesia on the Inammatory Response and S100 Protein During Coronary Artery Bypass Grafting
Elif Doan Baki,1,7 Mustafa Aldemir,2 Serdar Kokulu,1 Halit Bura Koca,3 Yksel Ela,1
Remziye Gl Svac,1 Nilgn Kavrut ztrk,4 Mustafa Emmiler,5 Fahri Adal,2
and Hanife Uzel6
AbstractCardiopulmonary bypass (CPB) contributes to the secretion of anti-inammatory cytokines that mediate the inammatory response observed during open heart surgery. In addition to many factors, type of anesthesia management affects immune response and central nervous system in cardiac surgery. The aim of this study was to assess the effect of propofol versus desurane anesthesia on systemic immune modulation and central nervous system on patients undergoing coronary artery bypass grafting. Forty patients undergoing elective coronary artery bypass graft surgery with CPB were included in this prospective randomized study. Patients were allocated to receive propofol (n=20) or desurane (n=20) for maintenance of anesthesia. The blood samples for IL-6, IL-8, TNF-, and S100 were drawn just prior to the operation before the induction of anesthesia, second before cardiopulmonary bypass, third after CPB, fourth 4 h postoperatively at the ICU. Major nding in our study is that S100 levels were lower in propofol group when compared to desurane anesthesia. And also immune reaction was less in patients exposed to desurane anesthesia when compared to propofol anesthesia as indicated by lower plasma concentrations of IL-8 and IL-6. Propofol is more preferable in terms of S100 for anesthetic management for CABG.
KEY WORDS: cardiopulmonary bypass; anesthesia; inammation.
INTRODUCTION
Cardiopulmonary bypass (CPB) contributes to the secretion of anti-inammatory cytokines that mediate the inammatory response observed during and after open heart surgery. Different factors have been implicated such as preoperative smoking, drugs, degree of surgical injury, and pre-existing lung and systemic diseases with type and duration of anesthesia [1, 2]. Interleukins (IL) are established markers of the magnitude of the systemic inammation after CPB as IL-6, IL-8, IL-10, and tumor necrosis factor-alpha (TNF- ) [3].
Complication following classical cardiac surgery is mainly caused by extracorporeal circulation and reperfusion beginning with inammatory system activation. Following, added to superpose respiratory failure, pulmonary damage,
1 Department of Anesthesia and Reanimation, Faculty of Medicine,
Afyon Kocatepe University, Ali etinkaya kampus,...