title: Metabolic and oxidative effects of sevoflurane and propofol in children undergoing surgery for congenital heart disease.
abstract: OBJECTIVE
  To evaluate the metabolic and oxidative effects of sevoflurane and propofol in children undergoing surgery for correction of congenital heart disease.
  
  
  METHODS
  Twenty children with acyanotic congenital heart disease, scheduled for elective cardiac surgery with cardiopulmonary bypass, age range 1 day to 14 years were randomly assigned to 2 groups: Group GP, programmed to receive total intravenous anesthesia with propofol and group GS scheduled to use balanced anesthesia with sevoflurane. Exclusion criteria were cyanotic heart disease or complex, association with other malformations, severe systemic diseases, infection or children undergoing treatment and palliative or emergency surgery. Blood samples were collected at three different time-points: T0, after radial artery cannulation, T1, 30 minutes after cardiopulmonary bypass (CPB) launch and T2, at the end of procedure. Parameters analyzed included thiobarbituric acid-reactive substance (TBARS), glutathione (GLN), lactate and pyruvate plasmatic concentrations.
  
  
  RESULTS
  TBARS, GSH, lactate and pyruvate concentrations did not change significantly by Friedman´s test. Lactate/pyruvate ratio (L/P) was >10 in both groups. There was a moderate Pearson correlation for TBARS, in T1 (r=0.50; p=0.13) e T2 (r=0.51;p=0.12). Pearson correlation was high between groups during CPB (T1) for lactate (r=0.68; p=0.02), pyruvate (r=0.75; p=0.01) and L/P ratio (r=0.83; p=0.003).
  
  
  CONCLUSIONS
  Anesthetic techniques investigated in this study showed a similar pattern, with no increase in metabolic substrates and oxidative stress during surgical correction of congenital heart defects in non-cyanotic children.
authors.affiliation: Walter Cantidio University Hospital and Experimental Surgery Research Laboratory (LABCEX), Federal University of Ceara, Fortaleza-CE, Brazil.
authors.forename: Danielle Maia Holanda
authors.initials: DM
authors.lastname: Dumaresq
authors.forename: Raquel Cavalcante de
authors.initials: RC
authors.lastname: Vasconcelos
authors.forename: Sergio Botelho
authors.initials: SB
authors.lastname: Guimarães
authors.forename: Sara Lúcia
authors.initials: SL
authors.lastname: Cavalcante
authors.forename: José Huygens Parente
authors.initials: JH
authors.lastname: Garcia
authors.forename: Aulo Roberto Leitão de
authors.initials: AR
authors.lastname: Vasconcelos
mesh_terms: D000293:Adolescent; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005978:Glutathione / Q000097:blood; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology*; D018384:Oxidative Stress / Q000187:drug effects; D015742:Propofol / Q000494:pharmacology*; D011446:Prospective Studies; D019289:Pyruvic Acid / Q000097:blood; D000077149:Sevoflurane; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism; D013997:Time Factors
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D017392:Thiobarbituric Acid Reactive Substances; D019344:Lactic Acid; D000077149:Sevoflurane; D019289:Pyruvic Acid; D005978:Glutathione; D015742:Propofol