ABSTRACT
Different pharmacological agents may decrease the inflammatory response during cardiac surgery. The aim of this study was to evaluate the effect of ascorbic acid as an antioxidant on inflammatory markers [interleukins 6 and interleukin 8] released during cardiopulmonary bypass. Forty patients scheduled for elective coronary artery bypass grafting surgery, were randomly assigned to two groups. The patients in the case group were given 3 grams ascorbic acid 12-18 hours before operation and 3 grams during CPB initiation. The patients in the control group were given the same amounts of normal saline at similar times. Blood samples were collected 6 hours preoperatively and postoperative serum interleukin 6 and 8 were measured using enzyme-linked immunosorbent assay [ELISA]. In both groups CPB caused an increase in IL6 and IL8 plasma concentrations ; compared with baseline levels, but the pattern of changes at such levels were similar in both groups after receiving ascorbic acid or placebo. Ascorbic acid did not reduce the inflammatory cytokines during CPB. Compared to the placebo, ascorbic acid had no significant effect on hemodynamic parameters such as systolic and diastolic blood pressure, heart rate, arterial blood gases, BUN, Creatinine and WBC and platelet counts. Ascorbic acid has no effect on the reduction of IL6 and IL8 during CPB. Also, it causes no improvement in hemodynamics, blood gas variables, and the outcomes of patients undergoing CABG
ABSTRACT
A marked stress response including hypertension, tachycardia, arrhythmias and an increase in intracranial pressure often follows direct laryngoscopy. This response can be harmful specially in patients with underlying cardiac disease. The intubating laryngeal mask airway [ILMA]-a new modified laryngeal mask airway-has been introduced that facilitates tracheal intubation without using laryngoscopy. Oropharyngeal stimulation-proposed as the probable cause of stress response-have been shown to be attenuated in ILMA. We conducted this study to evaluate the stress response following two techniques in patients undergoing coronary artery surgery which are most likely to benefit from decreased hemodynamic changes during intubation. In this trial, eighty patients, forty in ILMA group and forty in DL group were involved. To determine hemodynamic response during these manipulations, blood pressure [BP] and heart rate [HR] were recorded before and after anesthetic induction [one minute before and one, two and five minutes after successful intubation via either method]. A significant increase in heart rate and blood pressure was detected in both groups after intubation. Despite existence of noted changes in both groups; quantity of these changes was similar in both groups, however quality of changes was not completely similar. Finally we could hardly ascertain if intubation with ILMA is a prefered method in patients with high cardiac risk or not. But it seems that ILMA does not have much greater benefit over conventional DL in patients undergoing coronary artery by-pass grafting