Myocardial Ischemic Reperfusion Injury Clinical Trial
Official title:
The Effect of Sevoflurane-dexmedetomidine and Sevoflurane-remifentanil on Biochemical Markers During Open Heart Surgery
The aim of this study was to investigate the myocardial protective effects of remifentanil and dexmedetomidine in cardiac surgery.
Fifty patients is included in this study. Routine monitorization included a 5-lead
electrocardiogram (ECG), invasive arterial monitoring, pulse oximetry, capnography,
temperature monitoring. Invasive arterial catheter were inserted under local anesthesia.
Central venous catheter (jugular or subclavian) and esophageal heat probe were inserted
after tracheal intubation.
Anesthesia induction was standardized in all patients and included 1 mg/kg propofol, 1 μg/kg
fentanyl and 0.1 mg/kg vecuronium bromus to facilitate endotracheal intubation. The patients
were divided into two groups by computer randomization method. Group R (n=25), remifentanil
group and Group D (n=25) dexmedetomidine group. In the remifentanil group, anesthesia was
maintained with 0.5-1.5% sevoflurane and 0.125-0.25 μg/kg/min remifentanil infusion. In the
dexmedetomidine group anesthesia was maintained with 0.5-1.5% sevoflurane and 0.5 μg/kg
dexmedetomidine loading dose during 10 minute and 0.3-0.9 μg/kg/min infusion.
Cardiopulmonary bypass (CPB) period was started after aort and venous cannulae were
inserted. Mean arterial pressure, central venous pressure, venous oxygen saturation (SVO2)
and arterial blood gase analysis were recorded. All blood samples include laktat, pyruvate,
CKMB and Troponin-T were taken via the coronary sinus catheter at specific time intervals
(precardiopulmonary bypass, 20 minutes after cross clamp, 20 minutes after removal cross
clamp and 10 minutes after cardiopulmonary bypass).
Cardiopulmonary bypass time, aortic cross clamping time, the need of
defibrillation/intraaortic balloon pumping (IABP)/extracorporeal membrane oxygenator (ECMO),
urine output, positive inotropic agents requirement were recorded. At the end of surgery,
the patients were transferred intensive care unit intubated and full monitorized.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Prevention
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