title: Propofol Provides More Effective Protection for Circulating Lymphocytes Than Sevoflurane in Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery.
abstract: OBJECTIVE
  To compare the effects of propofol, sevoflurane, and the combination of the 2 on circulating lymphocytes in patients undergoing off-pump coronary artery bypass graft (OPCAB) surgery.
  
  
  METHODS
  A prospective, randomized study.
  
  
  METHODS
  A university hospital.
  
  
  METHODS
  One hundred five patients undergoing elective OPCAB surgery.
  
  
  METHODS
  Participants were randomized to receive sevoflurane (group S), propofol (group P), or coadministration (group C) of sevoflurane- and propofol-maintained anesthesia.
  
  
  RESULTS
  Blood samples were obtained before, during, and after surgery. Caspase-3 and apoptosis-inducing factor in lymphocytes were evaluated by Western blot. During surgery, 5 minutes after revascularization of the left anterior descending artery, 5 minutes after all anastomoses (T4), and after the sternal closure (T5), caspase-3 expression of group S was higher than that of group P (p = 0.02) and group C (p = 0.02). At T4 and T5, expression of active apoptosis-inducing factor in group S was higher than that in the other 2 groups (p = 0.03 and p = 0.04, respectively). 24 hours after surgery, the lymphocyte count of group S (0.55/nL) was lower than that of group P (0.73/nL, p = 0.02) and group C (0.73/nL, p = 0.03). Intensive care unit stay of group S (3.0 days) was longer than that of the other 2 groups (2.2 days, p = 0.02 and 2.1 days, p = 0.01).
  
  
  CONCLUSIONS
  OPCAB surgery was associated with postoperative lymphopenia. Regarding a protective effect for circulating lymphocytes, propofol and the combination of sevoflurane- and propofol-maintained anesthesia were both superior to sevoflurane-maintained anesthesia.
authors.affiliation: Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Lijie
authors.initials: L
authors.lastname: Jia
authors.affiliation: Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Rong
authors.initials: R
authors.lastname: Dong
authors.affiliation: Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Fujun
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, Zhejiang Provincial People's Hospital, Hangzhou, People's Republic of China.
authors.forename: Wenyuan
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Han
authors.initials: H
authors.lastname: Lu
authors.affiliation: Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Qingsheng
authors.initials: Q
authors.lastname: Xue
authors.affiliation: Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China. Electronic address: buwei_yu@163.com.
authors.forename: Buwei
authors.initials: B
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018685:Anesthetics, Inhalation / Q000097:blood / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000097:blood / Q000494:pharmacology*; D051033:Apoptosis Inducing Factor / Q000097:blood / Q000187:drug effects; D015153:Blotting, Western; D053148:Caspase 3 / Q000097:blood / Q000187:drug effects; D047549:Coronary Artery Bypass, Off-Pump; D004359:Drug Therapy, Combination; D006801:Humans; D008214:Lymphocytes / Q000187:drug effects*; D008297:Male; D008738:Methyl Ethers / Q000097:blood / Q000494:pharmacology*; D008875:Middle Aged; D015742:Propofol / Q000097:blood / Q000494:pharmacology*; D011446:Prospective Studies; D000077149:Sevoflurane; D055815:Young Adult
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D051033:Apoptosis Inducing Factor; D008738:Methyl Ethers; D000077149:Sevoflurane; D053148:Caspase 3; D015742:Propofol
keywords: apoptosis-inducing factor; cysteine-aspartic acid protease capsase-3; lymphocyte; off-pump coronary artery bypass graft; propofol; sevoflurane