Multimodal low-opioid anesthesia as a factor in reducing the activation of the proinflammatory response in cardiac surgery
The aim – to evaluate the effect of the low opioid anesthetic management scheme on the dynamics of cytokines (interleukin-6) during coronary artery bypass grafting (CABG). Materials and methods. The study included 120 patients with coronary heart disease who underwent CABG with application of 2-3 a...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
TOV Chetverta Khvylia
2019-12-01
|
| Series: | Кардіохірургія та інтервенційна кардіологія |
| Subjects: | |
| Online Access: | http://csic.com.ua/images/pdf/2019/4-2019/multimodal-low-opioid-anesthesia-factor-in-reducing-the-activation-proinflammatory-response-in-cardiac-surgery.pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832568660574601216 |
|---|---|
| author | S.R. Maruniak O.A. Loskutov O.M. Druzhyna I.R. Malysh V.G. Kolesnikov N.O. Korotchuk |
| author_facet | S.R. Maruniak O.A. Loskutov O.M. Druzhyna I.R. Malysh V.G. Kolesnikov N.O. Korotchuk |
| author_sort | S.R. Maruniak |
| collection | DOAJ |
| description | The aim – to evaluate the effect of the low opioid anesthetic management scheme on the dynamics of cytokines (interleukin-6) during coronary artery bypass grafting (CABG).
Materials and methods. The study included 120 patients with coronary heart disease who underwent CABG with application of 2-3 aortocoronary anastomoses under cardiopulmonary bypass. According to the anesthetic management, all patients were divided into two groups: the first group (n = 60) – low opioid multimodal anesthetic scheme; the second group (n = 60) – a standard scheme of anesthetic management. The determination of the level of interleukin-6 in the blood was carried out before and after the completion of cardiopulmonary bypass by enzyme-linked immunosorbent assay.
Results. Conducting a low opioid multimodal and standard anesthetic management scheme was characterized by a relatively similar effect on the dynamics of systolic blood pressure and heart rate during CABG with cardiopulmonary bypass, except intubation stage, at which these indicators were significantly lower by 16.21 % (p = 0.001) and by 15.45 % (p = 0.001), respectively, in patients with a low opioid anesthetic management scheme. In patients with low opioid multimodal anesthesia, the level of interleukin-6 at the end of the surgery was by 25.61 % lower (p < 0.0001) compared to the results in patients with a standard scheme of anesthesia. Intraoperative use of red blood cell was characterized by a significant increase in interleukin-6 levels at the end of surgery.
Conclusions. The use of a combination of ketamine, lidocaine and dexmedetomidine for multimodal low opioid anesthesia is characterized by relative safety, a sufficient level of analgesia and a low level of inflammatory response. |
| format | Article |
| id | doaj-art-b1cb9bc52de74ace86b3f14655e6a2fc |
| institution | Kabale University |
| issn | 2305-3127 |
| language | English |
| publishDate | 2019-12-01 |
| publisher | TOV Chetverta Khvylia |
| record_format | Article |
| series | Кардіохірургія та інтервенційна кардіологія |
| spelling | doaj-art-b1cb9bc52de74ace86b3f14655e6a2fc2025-02-03T00:54:41ZengTOV Chetverta KhvyliaКардіохірургія та інтервенційна кардіологія2305-31272019-12-014212810.31928/2305-3127-2019.4.2128Multimodal low-opioid anesthesia as a factor in reducing the activation of the proinflammatory response in cardiac surgeryS.R. Maruniak0O.A. Loskutov1O.M. Druzhyna2 I.R. Malysh3V.G. Kolesnikov4N.O. Korotchuk5Heart Institute, Ministry of Health of Ukraine, Kyiv, Ukraine; Shupyk National Medical Academy of Postgraduate Education, Kyiv, UkraineHeart Institute, Ministry of Health of Ukraine, Kyiv, Ukraine; Shupyk National Medical Academy of Postgraduate Education, Kyiv, UkraineHeart Institute, Ministry of Health of Ukraine, Kyiv, Ukraine; Shupyk National Medical Academy of Postgraduate Education, Kyiv, UkraineShupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine; Kyiv City Clinical Hospital for Emergency Medical Care, Kyiv, UkraineHeart Institute, Ministry of Health of Ukraine, Kyiv, Ukraine; Shupyk National Medical Academy of Postgraduate Education, Kyiv, UkraineHeart Institute, Ministry of Health of Ukraine, Kyiv, UkraineThe aim – to evaluate the effect of the low opioid anesthetic management scheme on the dynamics of cytokines (interleukin-6) during coronary artery bypass grafting (CABG). Materials and methods. The study included 120 patients with coronary heart disease who underwent CABG with application of 2-3 aortocoronary anastomoses under cardiopulmonary bypass. According to the anesthetic management, all patients were divided into two groups: the first group (n = 60) – low opioid multimodal anesthetic scheme; the second group (n = 60) – a standard scheme of anesthetic management. The determination of the level of interleukin-6 in the blood was carried out before and after the completion of cardiopulmonary bypass by enzyme-linked immunosorbent assay. Results. Conducting a low opioid multimodal and standard anesthetic management scheme was characterized by a relatively similar effect on the dynamics of systolic blood pressure and heart rate during CABG with cardiopulmonary bypass, except intubation stage, at which these indicators were significantly lower by 16.21 % (p = 0.001) and by 15.45 % (p = 0.001), respectively, in patients with a low opioid anesthetic management scheme. In patients with low opioid multimodal anesthesia, the level of interleukin-6 at the end of the surgery was by 25.61 % lower (p < 0.0001) compared to the results in patients with a standard scheme of anesthesia. Intraoperative use of red blood cell was characterized by a significant increase in interleukin-6 levels at the end of surgery. Conclusions. The use of a combination of ketamine, lidocaine and dexmedetomidine for multimodal low opioid anesthesia is characterized by relative safety, a sufficient level of analgesia and a low level of inflammatory response.http://csic.com.ua/images/pdf/2019/4-2019/multimodal-low-opioid-anesthesia-factor-in-reducing-the-activation-proinflammatory-response-in-cardiac-surgery.pdfcoronary artery bypass graftingcardiopulmonary bypasssystemic inflammatory response syndrome |
| spellingShingle | S.R. Maruniak O.A. Loskutov O.M. Druzhyna I.R. Malysh V.G. Kolesnikov N.O. Korotchuk Multimodal low-opioid anesthesia as a factor in reducing the activation of the proinflammatory response in cardiac surgery Кардіохірургія та інтервенційна кардіологія coronary artery bypass grafting cardiopulmonary bypass systemic inflammatory response syndrome |
| title | Multimodal low-opioid anesthesia as a factor in reducing the activation of the proinflammatory response in cardiac surgery |
| title_full | Multimodal low-opioid anesthesia as a factor in reducing the activation of the proinflammatory response in cardiac surgery |
| title_fullStr | Multimodal low-opioid anesthesia as a factor in reducing the activation of the proinflammatory response in cardiac surgery |
| title_full_unstemmed | Multimodal low-opioid anesthesia as a factor in reducing the activation of the proinflammatory response in cardiac surgery |
| title_short | Multimodal low-opioid anesthesia as a factor in reducing the activation of the proinflammatory response in cardiac surgery |
| title_sort | multimodal low opioid anesthesia as a factor in reducing the activation of the proinflammatory response in cardiac surgery |
| topic | coronary artery bypass grafting cardiopulmonary bypass systemic inflammatory response syndrome |
| url | http://csic.com.ua/images/pdf/2019/4-2019/multimodal-low-opioid-anesthesia-factor-in-reducing-the-activation-proinflammatory-response-in-cardiac-surgery.pdf |
| work_keys_str_mv | AT srmaruniak multimodallowopioidanesthesiaasafactorinreducingtheactivationoftheproinflammatoryresponseincardiacsurgery AT oaloskutov multimodallowopioidanesthesiaasafactorinreducingtheactivationoftheproinflammatoryresponseincardiacsurgery AT omdruzhyna multimodallowopioidanesthesiaasafactorinreducingtheactivationoftheproinflammatoryresponseincardiacsurgery AT irmalysh multimodallowopioidanesthesiaasafactorinreducingtheactivationoftheproinflammatoryresponseincardiacsurgery AT vgkolesnikov multimodallowopioidanesthesiaasafactorinreducingtheactivationoftheproinflammatoryresponseincardiacsurgery AT nokorotchuk multimodallowopioidanesthesiaasafactorinreducingtheactivationoftheproinflammatoryresponseincardiacsurgery |