The effects of intravenous aminoacid infusion on myocardial functions and postoperative analgesia during abdominal aortic surgery

Abstract

Objective: Effects of intravenous aminoacid infusion on myocardial functions and postoperative analgesia in abdominal aortic surgery were investigated. Materials and methods: Forty patients were randomly divided into groups of general anaesthesia with or without aminoacid infusion (Group 1 and 2, n=10), combined general+epidural with or without amino acid infusion (Group 3 and 4, n=10). Cardiac risk was evaluated using 2007 AHA/ ACC and modified Goldman classifications. Intravenous aminoacid solution of 80 g/L was infused at 2.5 ml/kg/h for a total of 8 hours. General anaesthesia included intravenous remifentanil, rocuronium, sevoflurane. The lumbar epidural include; 10 mL of 0.25% bupivacaine; bolus dose, an infusion of 0.25% bupivacaine; 4 ml/h for 24 hours. Heart rate, arterial blood pressures were collected intraoperative every 10 minute, 1, 24 hour postoperatively. Plasma creatine kinase MB fraction, troponin levels, pain assessment with numeric analog scale were collected preoperatively, 1, 24 hour postoperatively. Postoperative 24 hour analgesic usage, complications were recorded. Results: Patients with mild and severe cardiac risk were higher in 2007 AHA/ACC classification (26/40, 65%) than modified Goldman risk classification (5/40, 12.5%) (p=0.04). In comparison between groups, myocardial enzyme levels and complications showed no difference (p>0.05). The use of analgesics were lower in group 3 and 4 in comparison to group 1 and 2 (p=0.002). Conclusion: During abdominal aortic surgery, intravenous infusion of amino acid did not show significant changes on intraoperative and postoperative hemodynamic parameters and myocardial enzymes. The patients received combined general plus epidural anaesthesia showed more successful postoperative analgesia.