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BJA Advance Access originally published online on October 9, 2006
British Journal of Anaesthesia 2006 97(6):825-831; doi:10.1093/bja/ael270
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

The effects of propofol on neutrophil function, lipid peroxidation and inflammatory response during elective coronary artery bypass grafting in patients with impaired ventricular function

T.B. Corcoran*, A. Engel, H. Sakamoto, A. O'Shea, S. O'Callaghan-Enright and G. D. Shorten

Department of Anaesthesia and Intensive Care Medicine, Cork University/Mercy Hospitals and University College Cork Cork City, Ireland

*Corresponding author: Department of Intensive Care Medicine, Royal Perth Hospital, Wellington Street, Perth 6000, Western Australia. E-mail: mascor{at}bigpond.net.au

Background. Coronary artery bypass grafting (CABG) with cardiopulmonary bypass elicits a potent reperfusion injury and inflammatory response, more intense in patients with impaired myocardial function. Propofol has antioxidant properties which may attenuate such a response.

Methods. In total, 27 patients with impaired left ventricular function undergoing CABG were randomly allocated to receive either target-controlled infusion propofol (P) or saline (S) immediately before aortic cross-clamp release until 4 h after reperfusion. Troponin-I, Urinary 8-epi PGF-2{alpha} isoprostane, coronary sinus and systemic malondialdehyde concentrations, Interleukin-6 (IL-6), -8 and -10 concentrations and leucocytes function studies (neutrophil respiratory burst, phagocytosis, CD-11b and CD-18 expression) were measured.

Results. Propofol decreased MDA coronary sinus concentration at 1, 3 and 5 min after reperfusion (P<0.01); 60 min after reperfusion a significant difference between the two groups in systemic MDA concentrations was also seen. IL-6 concentration increases were significantly greater in Group S than Group P, 4 h after reperfusion [1118 (1333) pg ml–1 vs 228 (105) pg ml–1, P<0.01]. Serum IL-8 concentrations did not increase significantly in either group. Compared with baseline values IL-10 concentrations decreased after reperfusion but the values were higher in the propofol group than in the control group [22 (16) vs 11 (4) pg ml–1, P<0.05]. No difference in leucocyte function or urinary isoprostane concentrations was demonstrated.

Conclusion. Propofol attenuates free-radical-mediated lipid peroxidation and systemic inflammation in patients with impaired myocardial function undergoing CABG.


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