[Comparison of the effect of propofol and midazolam on serum level of cardiac troponin T following coronary artery bypass graft]

Cardiac surgery is associated with some degree of myocardial injury. Preconditioning was described first in 1986 and it classified into: pharmacologic and Non-pharmacologic. Volatile Anesthetic agents [Sevofluran] with stimulation of ischemic preconditioning can protect myocardium. At least one study has demonstrated the potential salutary effect of volatile anesthetic agents on cardiac Troponin T [cTnT] [a reliable marker of myocardial injury]. In another study Midazolam, Propofol and Sevofluran provides equal protection in pediatric cardiac surgery. To compare the effect of Midazolam and Propofol on the level of cTnT following CABG. In this clinical trial, double blind study 40 elected patients for CABG were randomly assigned to receive infusion of Propofol or Midazolam. Other surgical procedures and anesthetics were similar for both groups. Serum cTnT was measured preoperatively and at 12, 24 and 36hr post operation. Serum cTnT was significantly raised in both groups. In all postoperative episodes, cTnT concentration intended to be higher in Midazolam group than Propofol group, but this difference was not significant. The peak levels of cTnT [T12] in both groups were much lower than peak level of cTnT were much lower than peak level of cTnT in previous studies [in previous studies in midazolam group T12=0.260 [ +/- 0.1.71] ng/ml - in propofol group T12= 0.205 [ +/- 0.110] ng/ml]]. Midazolam and Propofol provided equal myocardial protection during CABG

[Effect of hemodynamic propofol and thiopemtal sodium and during electeroconvulsive therapy]

Introduction: For safe conduct of electro convulsive therapy [ECT] and decreasing the tissue physiological complication general anesthesia is recommended to patients

Objective: In this study we compared thiopental sodium and propofol as induction agent for ECT

Materials and Methods: Twenty-five patients each undergoing at least 2 sessions of ECT at the psychiatry department were included in the study. Each patient either received thiopental sodium or propofol for induction in a randomized manner. They are in ASA class I, II and don't have any contraindication for ECT. Patients with cardio- vascular problem and stroke were excluded from study. Patients were anesthetized in a randomized manner wit h 2.5 mg/kg thiopental and 1mg/kg propofol in separate session. Muscle relaxant drug dose was the same for all patients. Amount of energy shock administration can lead to effective tonic-clonic seizure in-patient. Mean arterial pressure and heart rate in 1,5 and 10 minute after ECT were evaluated. Meanwhile duration of seizure and verbal eye opening, discharge from recovery room and breathing rhythm in two groups were also evaluated

Results: The mean arterial pressure in proopfol group in 1,5 and 10 minute after ECT was respectively: [88.26 +/- 13.03] mm Hg, [92.50 +/- 10.01] mm Hg, [87.56 +/- 10.24] mm Hg. And in thiopental group in 1,5 and 10 minutes after ECT was respectively: [84.97 +/- 10.28] mm Hg, [104.13 +/- 7.85] mm Hg, [96.73 +/- 9.08] mm Hg, that was statistically significant [P< 0.00]. In the assessment of mean heart rate in 1,5 and 10 minute after ECT in thiopental group was respectively:[82.2 +/- 9.07] min, [110.04 +/- 7.08] min, [101.65 +/- 10.08] min. And in propofol group was respectively: [85.77 +/- 12.04] min, [98.75 +/- 11.02] min, [81.46 +/- 12.01] min which was statistically significant [P<0.05]. Duration of seizure in thiopental and propofol group was respectively: [31.08 +/- 4.13] min, [25.76 +/- 3.38] min. Time to verbal eye opening in thiopental and propofol group was respectively[5.04 +/- 1.36] min, [3.28 +/- 0.89] min. Discharging from recovery in thiopental and propofol group was respectively: [13.68 +/- 1.72] min, [10.28 +/- 1.05] min. Breathing rhythm time in thiopental and propofol group was respectively: [5.02 +/- 0.3] min [4.74 +/- 0.3]min which was statistically significant [P< 0.001]

Conclusion: Propofol offered a superior-hemodynamic stability during the procedure and a quick recovery from sleep. Propofol was found to be a better induction agent for ECT as compared to thiopental sodium