Comparison of the Effects of Desflurane and Propofol Anesthesia on the Inflammatory Response and S100β Protein During Coronary Artery Bypass Grafting

Abstract

Cardiopulmonary bypass (CPB) contributes to the secretion of anti-inflammatory cytokines that mediate the inflammatory response observed during open heart surgery. In addition to many factors, type of anesthesia management affects immune response and central nervous system in cardiac surgery. The aim of this study was to assess the effect of propofol versus desflurane anesthesia on systemic immune modulation and central nervous system on patients undergoing coronary artery bypass grafting. Forty patients undergoing elective coronary artery bypass graft surgery with CPB were included in this prospective randomized study. Patients were allocated to receive propofol (n = 20) or desflurane (n = 20) for maintenance of anesthesia. The blood samples for IL-6, IL-8, TNF-α, and S100β were drawn just prior to the operation before the induction of anesthesia, second before cardiopulmonary bypass, third after CPB, fourth 4 h postoperatively at the ICU. Major finding in our study is that S100β levels were lower in propofol group when compared to desflurane anesthesia. And also immune reaction was less in patients exposed to desflurane anesthesia when compared to propofol anesthesia as indicated by lower plasma concentrations of IL-8 and IL-6. Propofol is more preferable in terms of S100β for anesthetic management for CABG.

Comparison of the cerebroprotective effect of inhalation anaesthesia and total intravenous anaesthesia in patients undergoing cardiac surgery with cardiopulmonary bypass: a systematic review and meta-analysis

“…[17][18][19] All the articles had reported exclusion/inclusion criteria. [17][18][19][20][21][22][23][24][25][26][27][28][29] Of these, seven studies had used isoflurane versus TIVA, 17 19-21 23 24 27 four studies Open Access had used sevoflurane versus TIVA 18 22 25 26 and two studies had used desflurane versus TIVA 28 29 in patients.…”

Influence of Propofol, Isoflurane and Enflurance on Levels of Serum Interleukin-8 and Interleukin-10 in Cancer Patients

“…However, Tylman (Tylman et al, 2011) et al believed that these 2 anesthetic agents had similar impact on patients' immunological responses. Baki (Baki et al, 2013) et al randomly divided 40 patients with coronary artery diseases underwent selective operations into 2 groups and treated with propofol and desflurane respectively, and the results demonstrated that serum IL-6 and IL-8 levels in propofol group were evidently higher than those in desflurane group. Inhalation anesthesia of isoflurane or enflurance is commonly used in clinic, whose effect on organic cytokine expressions has become the research focus of abundant scholars (Kumakura et al, 2013).…”

Neuroprotective Strategies during Cardiac Surgery with Cardiopulmonary Bypass

“…Other drugs with expected immune modulatory effects have also been tested: the anesthetic propofol had a positive influence on the immune response after CPB [81]. Furthermore, it was found that S100β levels were lower in patients receiving propofol in contrast to patients under desflurane anesthesia [82].…”