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Gulhane Med J. 2010; 52(1): 018-022


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

Murat Kuyumcu1, Sibel Temür1, Murad Özsoy1, Çiğdem Tütüncü1, R.Eralp Ulusoy2, Sezai Özkan1, M.Hulusi Us3, Merih Gökben1.

Abstract
'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

Key words: Desflurane, fentanyl, reperfusion injury, sevoflurane



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