Comparison of the Effects of Propofol and Midazolam on Inflammation and Oxidase Stress in Children with Congenital Heart Disease Undergoing Cardiac Surgery.
10.3349/ymj.2011.52.2.326
- Author:
Wen fang XIA
1
;
Yu LIU
;
Qing shan ZHOU
;
Qi zhu TANG
;
Han dong ZOU
Author Information
1. Department of Critic Care Medicine, Renmin Hospital of Wuhan University, Wuhan, P.R. China. zhouqingshan2010@yahoo.com.cn
- Publication Type:Original Article ; Comparative Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
- Keywords:
Propofol;
midazolam;
cyanotic heart disease;
heme oxygenase-1
- MeSH:
Anesthesia, Intravenous/*adverse effects;
Anesthetics, Intravenous/*adverse effects;
Cardiac Surgical Procedures/*adverse effects;
Child;
Female;
Heart Defects, Congenital/*surgery;
Heme Oxygenase-1/blood;
Humans;
Inflammation/*chemically induced;
Interleukin-6/blood;
Interleukin-8/blood;
Male;
Malondialdehyde/blood;
Midazolam/*adverse effects;
Oxidative Stress/*drug effects;
Propofol/*adverse effects;
Superoxide Dismutase/blood
- From:Yonsei Medical Journal
2011;52(2):326-332
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To investigate and compare the effects of propofol and midazolam on inflammation and oxidase stress in children with congenital heart disease undergoing cardiac surgery. MATERIALS AND METHODS: Thirty-two ASA class I-II children with congenital heart disease undergoing cardiac surgery were randomly divided into two groups: propofol combined with low dose fentanyl (PF group, n = 16) and midazolam combined with low dose fentanyl (MF group, n = 16). Tracheal extubation time and length of Intensive Care Unit (ICU) stay were recorded. Blood samples were taken before operation (T0), at 2 h after release of the aorta cross-clamp (T3) and at 24 h after operation (T4) to measure interleukin 6 (IL-6), IL-8, superoxide dismutase (SOD) and malondialdehyde (MDA) levels. Myocardium samples were collected at 10-20 min after aorta cross-clamp (T1) and at 10-20 min after the release of the aorta cross-clamp (T2) to detect heme oxygenase-1 (HO-1) expression. RESULTS: Tracheal extubation time and length of ICU stay in PF group were significantly shorter than those of the MF group (p < 0.05, respectively). After cardiopulmonary bypass, IL-6, IL-8 and MDA levels were significantly increased, and the SOD level was significantly reduced in both two groups, but PF group exhibited lower IL-6, IL-8 and MDA levels and higher SOD levels than the MF group (p < 0.05, respectively). The HO-1 expression in the PF group was significantly higher than that in MF group at the corresponding time points (p < 0.05, respectively). CONCLUSION: Propofol is superior to midazolam in reducing inflammation and oxidase stress and in improving post-operation recovery in children with congenital heart disease undergoing cardiac surgery.
