Kuyumcu, Murat Gulhane Military Medical Academy - Haydarpasa Training Hospital - Department of Anesthesia and Reanimation, Turkey , Temür, Sibel Gulhane Military Medical Academy - Haydarpasa Training Hospital - Department of Anesthesia and Reanimation, Turkey , Özsoy, Murad Gulhane Military Medical Academy - Haydarpasa Training Hospital - Department of Anesthesia and Reanimation, Turkey , Tütüncü, Çiğdem Gulhane Military Medical Academy - Haydarpasa Training Hospital - Department of Anesthesia and Reanimation, Turkey , Ulusoy, R. Eralp Gulhane Military Medical Academy - Haydarpasa Training Hospital - Department of Cardiology, Turkey , Özkan, Sezai Gulhane Military Medical Academy - Haydarpasa Training Hospital - Department of Anesthesia and Reanimation, Turkey , Us, M. Hulusi Gulhane Military Medical Academy - Haydarpasa Training Hospital - Department of Cardiovascular Surgery, Turkey , Gökben, Merih Gulhane Military Medical Academy - Haydarpasa Training Hospital - Department of Anesthesia and Reanimation, Turkey

Comparison of the effects of total intravenous anesthesia and inhalation anesthesia on postperfusion injury in cardiac surgery

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In this study, we aimed to compare of the effects of two different anesthetic techniques (inhalation and total intravenous anesthesia) on ischemia-reperfusion injury in cases performed open-heart surgery. Fifty nine cardiopulmonary bypass patients were randomly assigned into one of three groups: Group I desflurane (n=20), Group II sevoflurane (n=20) and Group III total intravenous anesthesia (n=19) with fentanyl and midazolam. In Group I, anesthesia was established with i.v. infusion of 1-4 μg/kg/h fentanyl citrate and 1-3% desflurane, in Group II with i.v. infusion of 1-4 μg/kg/h fentanyl citrate and 1-1.5% sevoflurane, and with i.v. infusion of 0.3–12 μg/kg/min fentanyl citrate and 0.07 mg/kg/h midazolam in Group III. Arterial blood samples were taken in the preoperative period (S0), and at the 2nd (S1) and 24th hours (S2) postoperatively, and IL-6, IL-8, TNF-α, AST, ALT, CK-MB and cTnI levels were measured. In all groups, we observed similar rises in serum CK-MB, in cTnI and AST, the marker of myocardial cell injury, in ALT values, the marker of splanchnic circulation, and the levels of proinflammatory cytokines TNF-α, IL-6 and IL-8 at the postoperative 2nd and 24th hours compared with preoperative levels (p 0.001). In our particular experience there is no difference between inhalation and total intravenous anesthesia in the prevention of ischemic-reperfusion injury occurring during cardiopulmonary bypass and in the establishment of pharmacological preconditioning.

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Desflurane , fentanyl , reperfusion injury , sevoflurane

Gulhane Medical Journal

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