Effect of propofol with and without EDTA on haemodynamics and calcium and magnesium homeostasis during and after cardiac surgery.
OBJECTIVE
To determine the effect of the addition of disodium edetate (EDTA) to propofol on haemodynamics, ionised calcium and magnesium serum concentrations, and adverse events during cardiac surgery.


METHODS
Double-blind, randomised, multicenter trial.


METHODS
Operating room and intensive care unit of 5 academic health centres.


METHODS
A total of 102 evaluable patients, aged 34 to 85 years, undergoing first-time, elective coronary artery bypass graft surgery.


METHODS
Comparison of propofol with EDTA and propofol without EDTA, each in conjunction with the opioid sufentanil, for intraoperative anaesthesia and postoperative sedation.


RESULTS
There were no significant differences at any time between the two formulations in any clinical chemistry measurements, including ionised calcium, ionised magnesium, total calcium, parathyroid hormone, blood urea nitrogen, creatinine, sodium, potassium, and phosphate. During bypass, the mean concentration of ionised calcium decreased to below the normal range, but the decrease was similar in both groups (propofol with EDTA, 0.98 +/- 0.07 mmol/L [N = 51]; propofol, 0.99 +/- 0.10 mmol/ L [N = 51]; p = NS). Calcium concentration returned to normal after rewarming. Mean ionised magnesium concentrations remained within normal limits in both groups. Similarly, there were no clinically meaningful differences between treatments with respect to haemodynamic variables, efficacy variables, or incidence of adverse events.


CONCLUSIONS
The inclusion of EDTA in the current formulation of propofol appears to have no significant effects on calcium and magnesium profiles, renal function, haemodynamic variables, or other indicators of safety and efficacy during intraoperative anaesthesia and postoperative sedation in patients undergoing cardiac surgery.
Wahr
J
J
University of Michigan, Department of Anesthesia, Ann Arbor 48109-0048, USA. jwahr@umich.edu
Vender
J
J
Gilbert
H C
HC
Spiess
B
B
Horrow
J C
JC
Maddi
R
R
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D002118:Calcium / Q000378:metabolism; D006348:Cardiac Surgical Procedures; D002614:Chelating Agents / Q000494:pharmacology*; D004311:Double-Blind Method; D004492:Edetic Acid / Q000494:pharmacology*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006706:Homeostasis / Q000187:drug effects*; D006801:Humans; D008274:Magnesium / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011310:Preservatives, Pharmaceutical / Q000494:pharmacology*; D015742:Propofol / Q000494:pharmacology*; D018709:Statistics, Nonparametric
D018686:Anesthetics, Intravenous; D002614:Chelating Agents; D011310:Preservatives, Pharmaceutical; D004492:Edetic Acid; D008274:Magnesium; D002118:Calcium; D015742:Propofol