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

ABSTRACT

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