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INTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH

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Published by : Advanced Scientific Research
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0975-2366
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IJPR 9[3] July - September 2017 Special Issue

July - September 9[3] 2017

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Comparing the Effects of propofol and N–Acetylcysteine on Inflammatory Markers after Coronary Artery Bypass Surgery, A randomized clinical trial

Author: ANVARIPOUR ABDORASOUL, SHAHRYARI HOUSHANG, SHAFIEI EBRAHIM, MIRZAEI KAMRAN
Abstract: Anesthetic drugs used during cardiac surgery are posited to have anti–inflammatory effects. N–Acetylcysteine (NAC)is suggested to have antioxidant effects and is suggested to preserve systolic function, reduce myocardial oxidative stress, and enhance myocardial edema resolution after CPB or cardioplegic arrest. We aimed to compare the effects propofol and NAC on inflammatory markers after cardiopulmonary bypass (CPB). In this prospective parallel single– blind randomized clinical trial 80 candidates of elective coronary artery bypass grafting were recruited and allocated to two groups of propofol (P group) and N–Acetylcysteine (NAC group). The P group received propofol 100 µg/kg/minute peri–operatively with sufentanil (0.02 µg/kg/min), midazolam (1 µg/kg/min) and cis-atracurium (2.5 µg/kg/min) The NAC group received 600 mg N–acetylcysteine the day before surgery and 2 hours before induction of anesthesia with 100 cc water. In the NAC group, propofol was omitted in induction and maintenance of anesthesia and etomidate was used in induction of anesthesia as hypnotic agent. Serum levels of IL–1, IL–6 and TNF–a and systolic/diastolic blood pressure and heart rate were measured after induction of anesthesia, 15 minutes, 3 hours, and 24 hours after surgery. The groups were compared using non–parametric tests and analyzed by SPSS software. After intervention, IL–a levels significantly decreased in NAC group, while it increased significantly in P group. TNF–a levels significantly increased in NAC group, then decreased 24 hours after surgery, while it significantly increased in P group (15 min than baseline), but then decreased at 3 and 24 hours post–operatively. IL–6 levels decreased in both groups after 15 minutes postoperatively than baseline, but significantly increased in both groups at 3 hours and again decreased in both groups after 24 hours. IL–a level was significantly different after 15 minutes, 3 and 24 hours after surgery in both groups. But changes in the level of IL–ß and IL–6 were only significant at 24 hours and 15 minutes post–operatively, respectively, in both groups.Both drugs had similar anti–inflammatory effects, and can be used during CPB.
Keyword: Coronary Artery Bypass, Cardiopulmonary Bypass, Cytokines, Systemic Inflammatory Response Syndrome, Anesthesia
DOI: https://doi.org/10.31838/ijpr/2019.11.01.079
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