Propofol versus insulin cardioplegia in valvular heart surgeries assessed by myocardial histopathology and troponin I
Background and Aims Despite of the effectiveness of on pump cardiac surgeries in valvular diseases, cardioplegic arrest and myocardial reperfusion injury are still an obstacle. Many cardioprotective additives are tried but the obtained laboratory results are mixed. Our objective was to compare the e...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2022-12-01
|
| Series: | Egyptian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2022.2133760 |
| _version_ | 1798027546876444672 |
|---|---|
| author | Omyma Shehata Mohamed Shady Eid Al-Elwany Mina Maher Raouf Heba Mohamed Tawfik Ibrahim Abbas Youssef |
| author_facet | Omyma Shehata Mohamed Shady Eid Al-Elwany Mina Maher Raouf Heba Mohamed Tawfik Ibrahim Abbas Youssef |
| author_sort | Omyma Shehata Mohamed |
| collection | DOAJ |
| description | Background and Aims Despite of the effectiveness of on pump cardiac surgeries in valvular diseases, cardioplegic arrest and myocardial reperfusion injury are still an obstacle. Many cardioprotective additives are tried but the obtained laboratory results are mixed. Our objective was to compare the effects of supplementing the cardioplegia solution with propofol or insulin evaluated not only by laboratory biomarkers but also with papillary muscle biopsy in patients undergoing on pump valvular surgeries.Methods Sixty adult patients were randomly assigned into three equal groups to receive: cold blood cadioplegia (control (C) group), supplemented with either 9 mg/L propofol 10% (P group), or 10 IU/L regular insulin (I group)Results Propofol induced significant higher myocardial protection presented by better histopathological grading of the obtained muscle biopsies when compared to either group C (P = 0.0460) or group I (P = 0.014), lower postoperative dysrhythmia (P = 0.004), lower troponin I release (40.57 ± 8.5 vs 47.7 ± 6.22-fold increase), and more eukalemic state with lower need for K supplementation than insulin.Conclusion Propofol was superior to insulin in providing higher grade of myocardial protection with lower troponin I release, more steady K level and lower postoperative complications. |
| first_indexed | 2024-04-11T18:53:28Z |
| format | Article |
| id | doaj.art-be090b39841e424b8098c39b2e0f1b43 |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-04-11T18:53:28Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-be090b39841e424b8098c39b2e0f1b432022-12-22T04:08:17ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492022-12-0138158759610.1080/11101849.2022.2133760Propofol versus insulin cardioplegia in valvular heart surgeries assessed by myocardial histopathology and troponin IOmyma Shehata Mohamed0Shady Eid Al-Elwany1Mina Maher Raouf2Heba Mohamed Tawfik3Ibrahim Abbas Youssef4Department of Anesthesia and Intensive Care Unit. Minia University Hospital. Faculty of Medicine, Minia University, Minya EgyptDepartment of Cardiothoracic Surgery. Faculty of Medicine, Minia University, Minya EgyptDepartment of Anesthesia and Intensive Care Unit. Minia University Hospital. Faculty of Medicine, Minia University, Minya EgyptDepartment of Histopathology, Faculty of Medicine, Minia University, Minya EgyptDepartment of Anesthesia and Intensive Care Unit. Minia University Hospital. Faculty of Medicine, Minia University, Minya EgyptBackground and Aims Despite of the effectiveness of on pump cardiac surgeries in valvular diseases, cardioplegic arrest and myocardial reperfusion injury are still an obstacle. Many cardioprotective additives are tried but the obtained laboratory results are mixed. Our objective was to compare the effects of supplementing the cardioplegia solution with propofol or insulin evaluated not only by laboratory biomarkers but also with papillary muscle biopsy in patients undergoing on pump valvular surgeries.Methods Sixty adult patients were randomly assigned into three equal groups to receive: cold blood cadioplegia (control (C) group), supplemented with either 9 mg/L propofol 10% (P group), or 10 IU/L regular insulin (I group)Results Propofol induced significant higher myocardial protection presented by better histopathological grading of the obtained muscle biopsies when compared to either group C (P = 0.0460) or group I (P = 0.014), lower postoperative dysrhythmia (P = 0.004), lower troponin I release (40.57 ± 8.5 vs 47.7 ± 6.22-fold increase), and more eukalemic state with lower need for K supplementation than insulin.Conclusion Propofol was superior to insulin in providing higher grade of myocardial protection with lower troponin I release, more steady K level and lower postoperative complications.https://www.tandfonline.com/doi/10.1080/11101849.2022.2133760Propofolinsulincardioplegiavalvular surgery |
| spellingShingle | Omyma Shehata Mohamed Shady Eid Al-Elwany Mina Maher Raouf Heba Mohamed Tawfik Ibrahim Abbas Youssef Propofol versus insulin cardioplegia in valvular heart surgeries assessed by myocardial histopathology and troponin I Egyptian Journal of Anaesthesia Propofol insulin cardioplegia valvular surgery |
| title | Propofol versus insulin cardioplegia in valvular heart surgeries assessed by myocardial histopathology and troponin I |
| title_full | Propofol versus insulin cardioplegia in valvular heart surgeries assessed by myocardial histopathology and troponin I |
| title_fullStr | Propofol versus insulin cardioplegia in valvular heart surgeries assessed by myocardial histopathology and troponin I |
| title_full_unstemmed | Propofol versus insulin cardioplegia in valvular heart surgeries assessed by myocardial histopathology and troponin I |
| title_short | Propofol versus insulin cardioplegia in valvular heart surgeries assessed by myocardial histopathology and troponin I |
| title_sort | propofol versus insulin cardioplegia in valvular heart surgeries assessed by myocardial histopathology and troponin i |
| topic | Propofol insulin cardioplegia valvular surgery |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2022.2133760 |
| work_keys_str_mv | AT omymashehatamohamed propofolversusinsulincardioplegiainvalvularheartsurgeriesassessedbymyocardialhistopathologyandtroponini AT shadyeidalelwany propofolversusinsulincardioplegiainvalvularheartsurgeriesassessedbymyocardialhistopathologyandtroponini AT minamaherraouf propofolversusinsulincardioplegiainvalvularheartsurgeriesassessedbymyocardialhistopathologyandtroponini AT hebamohamedtawfik propofolversusinsulincardioplegiainvalvularheartsurgeriesassessedbymyocardialhistopathologyandtroponini AT ibrahimabbasyoussef propofolversusinsulincardioplegiainvalvularheartsurgeriesassessedbymyocardialhistopathologyandtroponini |