title: Comparison of TIVA and Desflurane Added to a Subanaesthetic Dose of Propofol in Patients Undergoing Coronary Artery Bypass Surgery: Evaluation of Haemodynamic and Stress Hormone Changes.
abstract: Introduction. Increased levels of stress hormones are associated with mortality in patients undergoing coronary artery bypass grafting (CABG). Aim. To compare total intravenous anaesthesia (TIVA) and desflurane added to a subanaesthetic dose of propofol. Material and Methods. Fifty patients were enrolled in this study. Fentanyl (3-5 mcg/kg/h) was started in both groups. Patients were divided into two groups. The PD group (n = 25) received 1 minimum alveolar concentration (MAC) desflurane anaesthesia in addition to propofol infusion (2-3 mg/kg/h), while P group (n = 25) received propofol infusion (5-6 mg/kg/h) only. Biochemical data, cortisol, and insulin levels were measured preoperatively (T0), after initiation of CPB but before cross-clamping the aorta (T1), after removal of the cross-clamp (T2), and at the 24th postoperative hour (T3). Results. Systolic, diastolic, and mean arterial pressure levels were significantly higher in PD group than those in P group in T1 and T2 measurements (p ≤ 0.05). CK-MB showed a significant decrease in group P (p ≤ 0.05). When we compared both groups, cortisol levels were significantly higher in PD group than P group (p ≤ 0.05). Conclusion. Stress and haemodynamic responses were better controlled using TIVA than desflurane inhalation added to a subanaesthetic dose of propofol in patients undergoing CABG.
authors.affiliation: Department of Anesthesiology, Erzincan University, 24030 Erzincan, Turkey.
authors.forename: Didem
authors.identifier: 0000-0001-8849-0531
authors.initials: D
authors.lastname: Onk
authors.affiliation: Department of Anesthesiology, Göztepe Training and Research Hospital, 34722 Istanbul, Turkey.
authors.forename: Tülin
authors.initials: T
authors.lastname: Akarsu Ayazoğlu
authors.affiliation: Department of Cardiovascular Surgery, Erzincan University, 24030 Erzincan, Turkey.
authors.forename: Oruç Alper
authors.initials: OA
authors.lastname: Onk
authors.affiliation: Department of Cardiovascular Surgery, Kartal Koşuyolu High Specialization Training and Research Hospital, 34865 Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Aksüt
authors.affiliation: Department of Biochemistry, Erzincan University, 24030 Erzincan, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Günay
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Necmettin Erbakan University, Meram School of Medicine, 42080 Konya, Turkey.
authors.forename: Kultigin
authors.initials: K
authors.lastname: Turkmen
authors.affiliation: Department of Anesthesiology, Kartal Koşuyolu High Specialization Training and Research Hospital, 34865 Istanbul, Turkey.
authors.forename: Aynur
authors.initials: A
authors.lastname: Özensoy
authors.affiliation: Department of Internal Medicine, Şişli Etfal Training and Research Hospital, 34363 Istanbul, Turkey.
authors.forename: Çiğdem
authors.initials: Ç
authors.lastname: Yazıcı Ersoy
authors.affiliation: Department of Biochemistry, Erzincan University, 24030 Erzincan, Turkey.
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Çoban
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000771:Anesthesia, Intravenous; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D001011:Aorta / Q000187:drug effects; D015415:Biomarkers; D015992:Body Mass Index; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D000077335:Desflurane; D005283:Fentanyl / Q000008:administration & dosage; D006439:Hemodynamics; D006728:Hormones / Q000097:blood; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery; D015742:Propofol / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D018685:Anesthetics, Inhalation; D015415:Biomarkers; D006728:Hormones; D000077335:Desflurane; D007530:Isoflurane; D005283:Fentanyl; D015742:Propofol