Protective effect of propofol and its relation to post-operation recovery in children undergoing
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Renmin Hospital of Wuhan University
Background: We hypothesized that propofol can exert protecive effect and improve patients’ post-operation recovery in children undergoing cardiac surgery with cardiopulmonary bypass (CPB).
Materials and Methods: Twenty ASA class I~II children with congenital heart disease undergoing cardiac surgery were randomly allocated to a propofol group (n=10) or a control group (n=10). Patients in the control group inhaled enflurane (0.25%-2%) for anesthesia maintenance, whereas those allocated to the propofol group received propofol (15-20mg/kg/h) intravenously. Blood samples were collected at four time points: before operation (T0), before the start of CPB (T1), 25 min after the aorta was cross-clamped (T2), 30 min after release of the aortic cross-clamp (T3),and 2h after the cessation of CPB (T4). Serum interleukin 6 (IL-6) level and the activities of serum lactate dehydrogenase (LDH), creatine phosphokinase (CK) and superoxide dismutase (SOD) were measured. The myocardial samples were collected at the time of incubation into right atrium before CPB and at 30min after reperfusion to observe the changes of morphology and to detect the expression of nuclear factor κB (NF-κB). Tracheal extubation time was recorded postoperatively.
Results: After CPB, LDH, CK and IL-6 levels were significantly increased in both two groups, and the SOD level was significantly reduced in the control group, but the propofol group exhibited lower LDH, CK and IL-6 levels and higher SOD levels than the control group (P<0.05, respectively). The expression of NF-κB in the propofol group was significantly lower than those in the control group after CPB (P<0.05).Tracheal extubation time in the propofol group was significantly shorter than that in the control group (P<0.05).
Conclusion: Propofol exerts protective effect and improves post-operation recovery through its antioxidant and antiinflammatory actions in children undergoing cardiac surgery with CPB.
Materials and Methods: Twenty ASA class I~II children with congenital heart disease undergoing cardiac surgery were randomly allocated to a propofol group (n=10) or a control group (n=10). Patients in the control group inhaled enflurane (0.25%-2%) for anesthesia maintenance, whereas those allocated to the propofol group received propofol (15-20mg/kg/h) intravenously. Blood samples were collected at four time points: before operation (T0), before the start of CPB (T1), 25 min after the aorta was cross-clamped (T2), 30 min after release of the aortic cross-clamp (T3),and 2h after the cessation of CPB (T4). Serum interleukin 6 (IL-6) level and the activities of serum lactate dehydrogenase (LDH), creatine phosphokinase (CK) and superoxide dismutase (SOD) were measured. The myocardial samples were collected at the time of incubation into right atrium before CPB and at 30min after reperfusion to observe the changes of morphology and to detect the expression of nuclear factor κB (NF-κB). Tracheal extubation time was recorded postoperatively.
Results: After CPB, LDH, CK and IL-6 levels were significantly increased in both two groups, and the SOD level was significantly reduced in the control group, but the propofol group exhibited lower LDH, CK and IL-6 levels and higher SOD levels than the control group (P<0.05, respectively). The expression of NF-κB in the propofol group was significantly lower than those in the control group after CPB (P<0.05).Tracheal extubation time in the propofol group was significantly shorter than that in the control group (P<0.05).
Conclusion: Propofol exerts protective effect and improves post-operation recovery through its antioxidant and antiinflammatory actions in children undergoing cardiac surgery with CPB.
