The effects of propofol on neutrophil function, lipid peroxidation and inflammatory response during elective coronary artery bypass grafting in patients with impaired ventricular function.
BACKGROUND
Coronary artery bypass grafting (CABG) with cardiopulmonary bypass elicits a potent reperfusion injury and inflammatory response, more intense in patients with impaired myocardial function. Propofol has antioxidant properties which may attenuate such a response.


METHODS
In total, 27 patients with impaired left ventricular function undergoing CABG were randomly allocated to receive either target-controlled infusion propofol (P) or saline (S) immediately before aortic cross-clamp release until 4 h after reperfusion. Troponin-I, Urinary 8-epi PGF-2alpha isoprostane, coronary sinus and systemic malondialdehyde concentrations, Interleukin-6 (IL-6), -8 and -10 concentrations and leucocytes function studies (neutrophil respiratory burst, phagocytosis, CD-11b and CD-18 expression) were measured.


RESULTS
Propofol decreased MDA coronary sinus concentration at 1, 3 and 5 min after reperfusion (P<0.01); 60 min after reperfusion a significant difference between the two groups in systemic MDA concentrations was also seen. IL-6 concentration increases were significantly greater in Group S than Group P, 4 h after reperfusion [1118 (1333) pg ml(-1) vs 228 (105) pg ml(-1), P<0.01]. Serum IL-8 concentrations did not increase significantly in either group. Compared with baseline values IL-10 concentrations decreased after reperfusion but the values were higher in the propofol group than in the control group [22 (16) vs 11 (4) pg ml(-1), P<0.05]. No difference in leucocyte function or urinary isoprostane concentrations was demonstrated.


CONCLUSIONS
Propofol attenuates free-radical-mediated lipid peroxidation and systemic inflammation in patients with impaired myocardial function undergoing CABG.
Corcoran
T B
TB
Department of Anaesthesia and Intensive Care Medicine, Cork University/Mercy Hospitals and University College Cork, Cork City, Ireland. mascor@bigpond.net.au
Engel
A
A
Sakamoto
H
H
O'Shea
A
A
O'Callaghan-Enright
S
S
Shorten
G D
GD
D000368:Aged; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007378:Interleukins / Q000097:blood; D015227:Lipid Peroxidation / Q000187:drug effects*; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control; D009504:Neutrophils / Q000187:drug effects* / Q000502:physiology; D015742:Propofol / Q000494:pharmacology*; D016897:Respiratory Burst / Q000187:drug effects; D018487:Ventricular Dysfunction, Left / Q000150:complications
D018686:Anesthetics, Intravenous; D018836:Inflammation Mediators; D007378:Interleukins; D008315:Malondialdehyde; D015742:Propofol