Protection by remote ischemic preconditioning during coronary artery bypass graft surgery with isoflurane but not propofol - a clinical trial.

摘要: Background Remote ischemic preconditioning (RIPC) of the myocardium by limb ischemia/reperfusion may mitigate cardiac damage, but its interaction with anesthetic regimen is unknown. We tested whether RIPC associated differential effects depending on background anesthesia. Specifically, we hypothesized that during isoflurane anesthesia attenuates myocardial injury in patients undergoing coronary artery bypass graft (CABG) surgery, and be different propofol anesthesia. Methods In a randomized, single-blinded, placebo-controlled prospective study, serum troponin I concentration (cTnI) (baseline, 1, 6, 12, 24, 48, 72 h postoperatively) were measured isoflurane/sufentanil or propofol/sufentanil without (three 5-min periods intermittent left upper arm ischemia 5 min reperfusion each) non-diabetic (n = 72) three-vessel disease (ClinicalTrials.govNCT01406678). Results RIPC (n = 20) decreased area under cTnI time curve (cTnI AUC) (−50%, 190 ± 105 ng/ml × 72 h vs. 383 ± 262 ng/ml × 72 h, P = 0.004), peak (7.3 ± 3.6 ng/ml 11.8 ± 5.5, P = 0.004) serial (P < 0.041) postoperative when compared to alone (n = 19). In contrast, (n = 14) did not alter AUC [263 ± 157 ng/ml × 72 h 372 ± 376 ng/ml × 72 h (n = 19), P = 0.318] (10.1 ± 4.5 ng/ml 12 ± 8.2, P = 0.444). None experienced harm side from ischemia. Conclusion Thus, damage CABG surgery. Accordingly, evoked depend anesthesia, combined RIPC/isoflurane exerting greater beneficial conditions studied.