Author/Authors :
Sedighinejad، Abbas نويسنده استاديار بيهوشي، فلوشيپ بيهوشي قلب، دانشگاه علوم پزشكي گيلان، بيمارستان پورسينا، بخش بيهوشي صديقي نژاد, عباس , Imantalab، Vali نويسنده Fellowship of Cardiac Anesthesia, Assistant Professor of Guilan University of Medical Sciences, Department of Cardiac Anesthesia, Heshmat Hospital , , Mirmansouri، Ali نويسنده , , Naderi Nabi، Bahram نويسنده Department of Anesthesiology, Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran , , Tarbiat، Masoud نويسنده Department of Anesthesia, Hamedan University of Medical Sciences, Hamedan, Iran , , Sadeghi، Ali Mohammad نويسنده Department of Cardiology, Assistant Professor of Cardiac
Surgery, Guilan University of Medical Sciences, Rasht,
Iran , , Nassiri Sheikhani، Nassir نويسنده MD, Assistant Professor of Cardiac Surgery, Department of Cardaic Surgery, Guilan University of Medical Sciences, Rasht, IR Iran , , Haghighi، Mohammad نويسنده , , Sayahe Varag، Zahra نويسنده Department of Anesthesiology, Anesthesiology Research
Center, Guilan University of Medical Sciences, Rasht,
Iran ,
Abstract :
Major surgeries such as open-heart surgery with cardiopulmonary
bypass are associated with a complexity of stress response leading to
post-operative complications. Studies have confirmed that anesthesia can
mitigate the surgically induced stress response. The aim of this study
was to compare the effects of propofol and isoflurane, both supplemented
with Sufentanil, on the stress response in coronary artery bypass graft
surgery with cardiopulmonary bypass, using cortisol as a biochemical
marker. This double-blind randomized clinical trial was conducted on 72
patients who underwent coronary artery bypass grafting (CABG) with
cardiopulmonary bypass meeting the inclusion criteria. The subjects were
randomly divided into two groups of isoflurane (n = 36) and propofol (n
= 36) both supplemented with sufentanil. Serum cortisol levels were
measured and compared between the groups; 30 minutes before the surgery
(T0), at the end of the cardiopulmonary bypass (T1), and 24 hours after
the surgery (T2). Compared to the baseline (T0), at the end of
cardiopulmonary bypass (T1), both groups demonstrated a decrease in
plasma cortisol levels with no statistical significant difference (P =
0.4). At T2 measuring time point, the level of plasma cortisol
significantly increased in both groups (P = 0.02), however this increase
was less in the Isoflurane group. In CABG with cardiopulmonary bypass,
using plasma cortisol level as a measure, Isoflurane-Sufentanil
significantly reduces the stress response to the surgery, when compared
to propofol-Sufentanil.
