Cardioprotective efficacy of sevoflurane vs. propofol during induction and/or maintenance in patients undergoing coronary artery revascularization surgery without pump: A randomized trial

International Journal of Cardiology
Jose L Guerrero OrriachJ Cruz Mañas

Abstract

Pre and post-operative administration of sevoflurane in myocardial revascularization surgery provides enhanced cardioprotective effects exerted by pharmacologic pre- and post-conditioning, as compared to propofol. The identification of the enzymes involved in conditioning mechanisms is crucial to the understanding of the effects of sevoflurane in cardiac surgery patients. The impact of sevoflurane on another crucial target organ-the kidney-was also assessed. Ninety patients undergoing off-pump myocardial revascularization surgery were allocated to receive either intra- and postoperative sevoflurane (SS), intraoperative sevoflurane and postoperative propofol (SP), or intra- and postoperative propofol (PP)). Troponin I and hemodynamic parameters were monitored during the first 48 postoperative hours; blood and urine samples were collected at baseline and at 24h to determine Akt, ERK1/2, PKG, iNO, bradykinin receptor, caspase 3, NT proBNP and urinary NGAL. The enzymes were overexpressed in the SS group, remained unchanged in the SP group, and decreased in the PP group. Renal function was best preserved in the SS group. The overexpression of enzymes induced by intraoperative anesthesia and postoperative sedation with sevoflurane re...Continue Reading

References

Mar 30, 2017·Drug Design, Development and Therapy·Jose Luis Guerrero-OrriachJose Cruz Mañas

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Citations

Sep 28, 2018·Current Medicinal Chemistry·Jose Luis Guerrero OrriachJose Cruz Mañas
Apr 30, 2019·Current Vascular Pharmacology·Jose L Guerrero Orriach, A Ramirez Fernandez
Oct 15, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Sophia LinYibin Wang
Oct 11, 2019·Current Vascular Pharmacology·Jose L Guerrero Orriach, A Ramirez-Fernandez
Dec 8, 2021·Current Opinion in Anaesthesiology·Benu MakkadMiklos D Kertai

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