by remote ischemic preconditioning during coronary artery bypass graft surgery with isoflurane but not propofol – a clinical trial

Cardiothoracic and Vascular Anesthesia


Protection by remote ischemic preconditioning during coronary artery bypass graft surgery with isoflurane but not propofol – a clinical trial


Kottenberg E, Thielmann M, Bergmann L, et al (Universitätsklinikum Essen, Germany) Acta Anaesthesiol Scand 56:30-38, 2012§



G.P. Gravlee, MD



Evidence Ranking


• A



Expert Rating


• 2



Abstract



Background


Remote ischemic preconditioning (RIPC) of the myocardium by limb ischemia/reperfusion may mitigate cardiac damage, but its interaction with the anesthetic regimen is unknown. We tested whether RIPC is associated with differential effects depending on background anesthesia. Specifically, we hypothesized that RIPC during isoflurane anesthesia attenuates myocardial injury in patients undergoing coronary artery bypass graft (CABG) surgery, and that effects may be different during propofol anesthesia.



Methods


In a randomized, single-blinded, placebo-controlled prospective study, serum troponin I concentration (cTnI) (baseline, and 1, 6, 12, 24, 48, and 72 h postoperatively) were measured during isoflurane/sufentanil or propofol/sufentanil anesthesia with or without RIPC (three 5-min periods of intermittent left upper arm ischemia with 5 min reperfusion each) in non-diabetic patients (n = 72) with three-vessel coronary artery disease (ClinicalTrials.gov(http://ClinicalTrials.gov)NCT01406678).

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Jan 28, 2017 | Posted by in ANESTHESIA | Comments Off on by remote ischemic preconditioning during coronary artery bypass graft surgery with isoflurane but not propofol – a clinical trial

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