Author/Authors :
Imantalab، Vali نويسنده Fellowship of Cardiac Anesthesia, Assistant Professor of Guilan University of Medical Sciences, Department of Cardiac Anesthesia, Heshmat Hospital , , Seddighi Nejad، Abbas نويسنده Department of Cardiac anesthesia, Rasht University of Medical Sciences, Rasht, IR Iran , , Mir Mansouri، Ali نويسنده Fellowship of Cardiac Anesthesia, Assistant Professor of Guilan University of Medical Sciences, Department of Cardiac Anesthesia, Heshmat Hospital , , Sadeghi Meibodi، Alimohammad نويسنده Cardiac Surgeon, Assistant Professor of Guilan University of Medical Sciences , , Haghighi، Mohammad نويسنده Department of Cardiac anesthesia, Rasht University of Medical Sciences, Rasht, IR Iran , , Dadkhah، Heidar نويسنده Cardiac Surgeon, Assistant Professor of Guilan University of Medical Sciences , , Mobayen، Mohammadreza نويسنده Department of Burn Surgery, Motahari Burn Hospital, Rasht University of Medical Sciences, Tehran, IR Iran ,
Abstract :
Background: Cardiac surgery is associated with some degree of myocardial injury. Preconditioning first described in 1986 was pharmacologic and non- pharmacologic. Among the long list of anesthetic drugs, isoflurane as an inhaling agent along with midazolam and propofol as injectable substances have been documented to confer some preconditioning effects on myocardium.
Objectives: In this study cardiac Troponin T (cTnT) ,as a reliable marker, was used for evaluating myocardial injury.
Methods: This prospective double blind study was comprised of 60 patients scheduled for CABG and were randomly assigned into three groups who received infusion of propofol or midazolam or isoflorane. Surgical procedures and anesthetics were similar for 3 groups. cTnT measured preoperatively and at 12, 24 and 36hr after arrival in ICU.
Results: There were no statistically significant differences in mean cTnT levels between three groups in the preoperative period and 12-24 hours after arrival in ICU. However, mean cTnT in 3 groups at 36 hours after arrival in ICU were different (P < 0.013) and cTnT level was significantly higher in midazolam group (P < 0.001) and lowest in isoflurane group (P=0.002).
Conclusion: There were significant differences on cTnT levels between anesthetic groups of isofluran, midazolam and propofol at 36 hr after surgery. Preconditioning effect of isoflurane was higher than the other two groups.
