A prospective, randomised, single-blind pilot study to determine the effect of anaesthetic technique on troponin T release after off-pump coronary artery surgery.
Ischaemic damage to the myocardium inevitably occurs during coronary artery surgery. However, the extent of the damage may be influenced by the anaesthetic technique used. The most sensitive and reliable marker of myocardial damage is currently thought to be troponin T. We conducted a prospective, randomised, single-blind pilot study to determine the baseline values of troponin T release after off-pump coronary artery bypass surgery in 30 patients randomly allocated to receive either propofol, isoflurane or isoflurane and high thoracic epidural analgesia. All other treatment was standardised. Patients undergoing emergency surgery and those with unstable angina were excluded. Blood samples were taken at 0, 3, 6, 12, 24 and 48 h after surgery for troponin T analysis. Mean troponin T levels at 24 h were not significantly different between the groups (p = 0.41). These data allows appropriate power calculations for further, large-scale studies to determine the anaesthetic technique that provides optimal myocardial protection.
Kendall
J B
JB
The Cardiothoracic Centre, Thomas Drive, Liverpool, UK. jbkendall@doctors.org.uk
Russell
G N
GN
Scawn
N D A
ND
Akrofi
M
M
Cowan
C M
CM
Fox
M A
MA
D000368:Aged; D000767:Anesthesia, Epidural; D000768:Anesthesia, General / Q000379:methods*; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007530:Isoflurane; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D010865:Pilot Projects; D015742:Propofol; D011446:Prospective Studies; D016037:Single-Blind Method; D020107:Troponin T / Q000097:blood*
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D015415:Biomarkers; D020107:Troponin T; D007530:Isoflurane; D015742:Propofol