PMID: 18212693Jan 24, 2008Paper

The effect of combined preinduction thoracic epidural anaesthesia and glucocorticoid administration on perioperative interleukin-10 levels and hyperglycemia. A randomized controlled trial

The Journal of Cardiovascular Surgery
L KiliçkanO Bayindir

Abstract

Anti-inflammatory cytokines such as interleukin-10 (IL-10) play a key role in the anti-inflammatory cascade after cardiopulmonary bypass (CPB). Even moderate hyperglycemia can increase mortality/morbidity, stroke, and myocardial infarction after coronary artery bypass grafting (CABG). The purpose of our study was to investigate whether preinduction thoracic epidural anesthesia (TEA) and preinduction glucocorticoid have an effect on perioperative anti-inflammatory and perioperative hyperglycemia in patients undergoing CABG with CPB. Sixty low-risk patients (n=60) undergoing elective CABG were randomly allocated into 4 groups: Group corticosteroid (Group S) (n=15) received 6-methylprednisolone 15 mg/kg IV 60 min before induction; Group TEA+corticosteroid (Group TEA+S) (n=15) received 20 mg bupivacaine in bolus 60 min before induction followed by 20 mg/h bupivacaine infusion intraoperatively and postoperatively via epidural catheter. Group TEA (n=15) received 20 mg bupivacaine in bolus 60 min before induction followed by 20 mg/h bupivacaine infusion intraoperatively and postoperatively via epidural catheter. Group control (Group C) (n=15) received neither preinduction TEA nor a preinduction steroid. Blood samples were sequentially...Continue Reading

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