ABSTRACT

In this study, we aimed to compare of the effects of two different anesthetic techniques (inhalation and total intravenous anesthesia) on ischemia-reperfusion injury in cases performed open-heart surgery. Fifty nine cardiopulmonary bypass patients were randomly assigned into one of three groups: Group I desflurane (n=20), Group II sevoflurane (n=20) and Group III total intravenous anesthesia (n=19) with fentanyl and midazolam. In Group I, anesthesia was established with i.v. infusion of 1-4 μg/kg/h fentanyl citrate and 1-3% desflurane, in Group II with i.v. infusion of 1-4 μg/kg/h fentanyl citrate and 1-1.5% sevoflurane, and with i.v. infusion of 0.3–12 μg/kg/min fentanyl citrate and 0.07 mg/kg/h midazolam in Group III. Arterial blood samples were taken in the preoperative period (S0), and at the 2nd (S1) and 24th hours (S2) postoperatively, and IL-6, IL-8, TNF-α, AST, ALT, CK-MB and cTnI levels were measured. In all groups, we observed similar rises in serum CK-MB, in cTnI and AST, the marker of myocardial cell injury, in ALT values, the marker of splanchnic circulation, and the levels of proinflammatory cytokines TNF-α, IL-6 and IL-8 at the postoperative 2nd and 24th hours compared with preoperative levels (p<0.001). In our particular experience there is no difference between inhalation and total intravenous anesthesia in the prevention of ischemic-reperfusion injury occurring during cardiopulmonary bypass and in the establishment of pharmacological preconditioning.