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. 2016 Nov 21;6(6):e42066.
doi: 10.5812/aapm.42066. eCollection 2016 Dec.

Comparing the Effects of Isoflurane-Sufentanil Anesthesia and Propofol-Sufentanil Anesthesia on Serum Cortisol Levels in Open Heart Surgery with Cardiopulmonary Bypass

Abbas Sedighinejad  1 , Vali Imantalab  1 , Ali Mirmansouri  1 , Bahram Naderi Nabi  2 , Masoud Tarbiat  1 , Ali Mohammad Sadeghi  3 , Nassir Nassiri Sheikhani  3 , Mohammad Haghighi  4 , Zahra Sayahe Varag  5
Affiliations

Comparing the Effects of Isoflurane-Sufentanil Anesthesia and Propofol-Sufentanil Anesthesia on Serum Cortisol Levels in Open Heart Surgery with Cardiopulmonary Bypass

Abbas Sedighinejad et al. Anesth Pain Med. .

Abstract

Background: Major surgeries such as open-heart surgery with cardiopulmonary bypass are associated with a complexity of stress response leading to post-operative complications. Studies have confirmed that anesthesia can mitigate the surgically induced stress response.

Objectives: The aim of this study was to compare the effects of propofol and isoflurane, both supplemented with Sufentanil, on the stress response in coronary artery bypass graft surgery with cardiopulmonary bypass, using cortisol as a biochemical marker.

Methods: This double-blind randomized clinical trial was conducted on 72 patients who underwent coronary artery bypass grafting (CABG) with cardiopulmonary bypass meeting the inclusion criteria. The subjects were randomly divided into two groups of isoflurane (n = 36) and propofol (n = 36) both supplemented with sufentanil. Serum cortisol levels were measured and compared between the groups; 30 minutes before the surgery (T0), at the end of the cardiopulmonary bypass (T1), and 24 hours after the surgery (T2).

Results: Compared to the baseline (T0), at the end of cardiopulmonary bypass (T1), both groups demonstrated a decrease in plasma cortisol levels with no statistical significant difference (P = 0.4). At T2 measuring time point, the level of plasma cortisol significantly increased in both groups (P = 0.02), however this increase was less in the Isoflurane group.

Conclusions: In CABG with cardiopulmonary bypass, using plasma cortisol level as a measure, Isoflurane-Sufentanil significantly reduces the stress response to the surgery, when compared to propofol-Sufentanil.

Keywords: CABG; Cardiopulmonary Bypass; Cortisol; Isoflurane-Sufentanil; Propofol-Sufentanil.

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Figures

Figure 1.
Figure 1.. Progress of Participants During Survey
Figure 2.
Figure 2.. Mean Cortisol Values in Patients Undergoing Cardiopulmonary Bypass
See this image and copyright information in PMC

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