A comparative study of cardioprotective effect of three anesthetic agents by measuring serum level of troponin-T after coronary artery bypass grafting.
BACKGROUND
Cardiac surgery is associated with some degree of myocardial injury. Preconditioning first described in 1986 was pharmacologic and non- pharmacologic. Among the long list of anesthetic drugs, isoflurane as an inhaling agent along with midazolam and propofol as injectable substances have been documented to confer some preconditioning effects on myocardium.


OBJECTIVE
In this study cardiac Troponin T (cTnT) ,as a reliable marker, was used for evaluating myocardial injury.


METHODS
This prospective double blind study was comprised of 60 patients scheduled for CABG and were randomly assigned into three groups who received infusion of propofol or midazolam or isoflorane. Surgical procedures and anesthetics were similar for 3 groups. cTnT measured preoperatively and at 12, 24 and 36hr after arrival in ICU.


RESULTS
There were no statistically significant differences in mean cTnT levels between three groups in the preoperative period and 12-24 hours after arrival in ICU. However, mean cTnT in 3 groups at 36 hours after arrival in ICU were different (P< 0.013) and cTnT level was significantly higher in midazolam group (P<0.001) and lowest in isoflurane group (P=0.002).


CONCLUSIONS
There were significant differences on cTnT levels between anesthetic groups of isofluran, midazolam and propofol at 36 hr after surgery. Preconditioning effect of isoflurane was higher than the other two groups.
Department of Cardiac anesthesia, Rasht University of Medical Sciences, Rasht, IR Iran.
Vali
V
Imantalab
Department of Cardiac anesthesia, Rasht University of Medical Sciences, Rasht, IR Iran.
Abbas
A
Seddighi Nejad
Department of Cardiac anesthesia, Rasht University of Medical Sciences, Rasht, IR Iran.
Ali
A
Mir Mansouri
Department of Cardiac anesthesia, Rasht University of Medical Sciences, Rasht, IR Iran.
Alimohammad
A
Sadeghi Meibodi
Department of Cardiac anesthesia, Rasht University of Medical Sciences, Rasht, IR Iran.
Mohammad
M
Haghighi
Department of Cardiac anesthesia, Rasht University of Medical Sciences, Rasht, IR Iran.
Heidar
H
Dadkhah
Department of Burn Surgery, Motahari Burn Hospital, Rasht University of Medical Sciences, Tehran, IR Iran.
Mohammadreza
M
Mobayen
Cardiac Surgery; Ischemia Preconditioning; Isoflurane; Midazolam; Propofol; Troponin T