Key result
TIVA yields lower cortisol and arterial pressures than desflurane plus propofol.
Why the study?
Does TIVA compared to desflurane with subanaesthetic propofol improve haemodynamic and stress hormone responses in patients undergoing CABG?
RCT (n=50)
Does TIVA compared to desflurane with subanaesthetic propofol improve haemodynamic and stress hormone responses in patients undergoing CABG?
p-value: p=≤0.05
TIVA with propofol provides better control of stress and haemodynamic responses compared to desflurane with subanaesthetic propofol in patients undergoing CABG.
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.
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Önk et al. (2016) conducted an RCT in Coronary artery bypass grafting (CABG) (n=50). Total intravenous anaesthesia (TIVA) with propofol vs. 1 MAC desflurane plus 2-3 mg/kg/h propofol infusion was evaluated on Haemodynamic and stress hormone changes (cortisol, insulin, CK-MB, arterial pressure) (p=≤0.05). Total intravenous anaesthesia (TIVA) better controlled stress and haemodynamic responses, yielding significantly lower cortisol levels and arterial pressures than desflurane plus propofol (p≤0.05).
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