Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi University, Tıp Fakültesi, Turkey
Approval Date: 2008
Thesis Language: Turkish
Student: Alper Tunga DOGAN
Supervisor: ÖMER KURTİPEK
Abstract:The aim of this study is, in terms of intraoperative myocardial ischemia, to compare the effects of desflurane with sevoflurane to ST-segment changes, cardiac enzyme and tumour necrosis factor- (TNF- ) values in patients undergoing coronary artery bypass grafting surgery (CABGS). Thirty-one patients undergoing elective CABGS were randomly allocated into two groups; in Group D desflurane and in Group S sevoflurane was administered. Remifentanil was administered at a constant infusion dose during the operation and depth of anesthesia was adjusted by modifying volatile anesthetics delivered fraction to achieve an anesthetic state with a bispectral index value in the range of 40-60. Hemodynamic parameters, ST-segment changes, cardiac output and minimum alveolar concentrations (MAC) were recorded. Blood samples were drawn for cardiac enzyme and TNF- assay before induction of anesthesia and at intra- and postoperative time periods. Intraoperative and postoperative complications were recorded. Hemodynamic parameters, ST-segment changes, cardiac output and bispectral index values were similar between the two groups. Reduction of MAC values attributed to remifentanil were significantly higher in Group D than Group S. Creatine kinase-MB and troponin-T values were similar between the groups. In Group D TNF- levels at the postoperative 2nd hour was found significantly lower than Group S. The skin closure and postoperative 24th hour TNF- values were lower than Group D. We conclude that, during the anesthesia for CABGS desflurane and sevoflurane protect the myocardium identically that can be detected by ST-segment changes, creatine kinase-MB and troponin-T levels and at the early postoperative period desflurane and sevoflurane blocks the inflammatory response similarly, which can be shown by TNF- values.