title: Sevoflurane at 1 MAC provides optimal myocardial protection during off-pump CABG.
abstract: OBJECTIVE
  We investigated the myocardial protective effect of sevoflurane in patients receiving off-pump coronary artery bypass grafting (OPCABG) and the role of brain natriuretic peptide (BNP).
  
  
  METHODS
  Forty-eight patients receiving elective OPCABG were randomly assigned to a control group, and to 0.75 MAC, 1.0 MAC and 1.5 MAC sevoflurane groups. Blood samples were collected and levels of BNP and cardiac troponin I (cTnI) were measured before anesthesia, and immediately, 24, 48 and 72 h after surgery.
  
  
  RESULTS
  Dopamine was necessary to maintain blood pressure in the sevoflurane groups, but not in the control group (p < 0.002). 1.0 MAC sevoflurane significantly decreased post-surgical cTnI levels (p < 0.001). 0.75 MAC had no significant effect, and increasing sevoflurane concentrations to 1.5 MAC caused no further decrease in cTnI concentrations. There was no significant difference in BNP level among the groups (p = 0.227) or between any two groups, although values of BNP showed a significant correlation with cTnI values in control subjects immediately after (r = 0.847) and 24 h after (r = 0.661) surgery.
  
  
  CONCLUSIONS
  Our results demonstrated that 1.0 MAC and 1.5 MAC sevoflurane can exert a significant myocardial protective effect. BNP cannot be used to predict the myocardial protective effect of sevoflurane in OPCABG.
authors.affiliation: Departments of Anesthesiology, The First Affiliated Hospital of Xinjiang, Medical University, Urumqi, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Wang
authors.forename: Hong
authors.initials: H
authors.lastname: Zheng
authors.forename: Chun-Ling
authors.initials: CL
authors.lastname: Chen
authors.forename: Wei
authors.initials: W
authors.lastname: Lu
authors.forename: Yong-Qiang
authors.initials: YQ
authors.lastname: Zhang
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002681:China; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects; D004298:Dopamine / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D017558:Elective Surgical Procedures; D005260:Female; D006331:Heart Diseases / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011446:Prospective Studies; D000077149:Sevoflurane; D013997:Time Factors; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood
chemical_list: D018685:Anesthetics, Inhalation; D015415:Biomarkers; D002316:Cardiotonic Agents; D008738:Methyl Ethers; D019210:Troponin I; D020097:Natriuretic Peptide, Brain; D000077149:Sevoflurane; D004298:Dopamine