Calcium chloride minimizes the hemodynamic effects of propofol in patients undergoing coronary artery bypass grafting.
OBJECTIVE
To assess the hemodynamic effects of propofol and the counteracting effect of calcium chloride (CaCl2) in patients undergoing coronary artery bypass grafting (CABG).


METHODS
Prospective, randomized study.


METHODS
University hospital, department of cardiac surgery.


METHODS
Fifty-eight patients undergoing elective CABG, divided into group A (n = 29) and group B (n = 29).


METHODS
Anesthesia was induced with a combination of fentanyl, 7 microg/kg; pancuronium, 0.1 mg/kg; and propofol, 1.5 mg/kg, administered over 60 seconds. A blinded investigator administered saline in group A patients and 10 mg/kg of CaCl2 in group B patients at the same speed and same time as propofol administration through another lumen of the central venous catheter.


RESULTS
Hemodynamic data were obtained at baseline (T0), 2 minutes after anesthesia induction (T1), and 2 minutes after tracheal intubation (T2). Heart rate decreased significantly in group A patients (86.2+/-11.3 beats/min at T0 and 72.8+/-7.5 beats/min at T2; p < 0.001). Mean arterial pressure decreased significantly in patients in both groups (group A, 108.0+/-12.0 mmHg at T0; 74.6+/-14.6mmHg at T2;p < 0.001 and group B, 106.0+/-10.2 mmHg at T0; 90.4+/-10.0 mmHg at T2; p < 0.05). Stroke volume index, cardiac index, and cardiac output decreased in group A patients (39.4+/-4.1 mL/beat/m2 at T0 and 28.8+/-5.2 mL/beat/m2 at T2; p < 0.05; 3.4+/-0.6 L/min/m2 at T0 and 1.9+/-0.3 L/min/m2 at T2; p < 0.001; 5.9+/-0.9 L/min at T0 and 3.4+/-0.4 L/min at T2; p < 0.001, respectively), whereas in group B patients, changes were negligible (38.1+/-7.0 mL/beat/m2 at T0 v 35.7+/-6.6 mL/beat/m2 at T2; (NS) 3.3+/-0.5 L/min/m2 at T0 v 2.7+/-0.3 L/min/m2 at T2; (NS) 5.7+/-0.9 L/min at T0 v 4.7+/-0.5 L/min at T2; (NS), respectively).


CONCLUSIONS
Simultaneous administration of CaCl2 during the induction of anesthesia minimizes the potential negative effect of propofol on cardiac function in cardiac patients.
Tritapepe
L
L
Department of Anesthesia and Intensive Care, University of Rome La Sapienza, Azienda Ospedaliera S Giovanni e Addolorata, Italy.
Voci
P
P
Marino
P
P
Cogliati
A A
AA
Rossi
A
A
Bottari
B
B
Di Marco
P
P
Menichetti
A
A
D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D002122:Calcium Chloride / Q000627:therapeutic use*; D002302:Cardiac Output / Q000187:drug effects; D002405:Catheterization, Central Venous; D001026:Coronary Artery Bypass; D017558:Elective Surgical Procedures; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage; D010197:Pancuronium / Q000008:administration & dosage; D010919:Placebos; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D020011:Protective Agents / Q000627:therapeutic use*; D016037:Single-Blind Method; D012965:Sodium Chloride; D013318:Stroke Volume / Q000187:drug effects
D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D010919:Placebos; D020011:Protective Agents; D012965:Sodium Chloride; D010197:Pancuronium; D002122:Calcium Chloride; D005283:Fentanyl; D015742:Propofol