Tramadol provides a cardioprotective effect against myocardial ischemia-reperfusion in isolated rat heart.

No abstract

Sixty children undergoing inguinal or urogenital surgery were allocated randomly to three groups to receive a caudal injection of either 0.125% bupivacaine 0.75 mL kg-1 with 0.5% midazolam 50 micrograms kg-1 (n = 20) or with 1% morphine chlorhydrate 0.05 mg kg-1 (n = 20), or bupivacaine alone (n = 20) after surgery under general anaesthesia. There were no significant changes in heart rate, blood pressure, respiratory rate or oxygen haemoglobin saturation values in all groups, and there were no significant differences in the incidence of vomiting and pruritus between the groups (P > 0.05). Sedation scores were higher in the bupivacaine-midazolam and the bupivacaine-morphine groups than in the bupivacaine group at 8-12 h post-operatively (P < 0.01). The durations of analgesia were 21.15 +/- 1.2 h in the bupivacaine-midazolam group, 14.50 +/- 1.6 h in the bupivacaine-morphine group and 8.15 +/- 1.3 h in the bupivacaine group. Differences between the bupivacaine-midazolam group and the bupivacaine group (P < 0.001), the bupivacaine-midazolam group and the bupivacaine-morphine group (P < 0.01), and the bupivacaine-morphine group and the bupivacaine group (P < 0.01) were significant. It is suggested that caudal administration of a bupivacaine-midazolam mixture produces a longer duration of post-operative analgesia than a bupivacaine-morphine mixture and bupivacaine alone with sedation for 8-12 h post-operatively.

ÖZETAmaç: Bu prospektif randomize çalışmanın amacı sevofluran ve isofluranın koroner baypas cerrahisi sırasında miyokart üzerindeki koruyucu etkilerini karşılaştırmaktır. Yöntemler: Etomidat (0.3 mg /kg ) ile genel anestezi indüksiyonunu takiben 0.1 mg/kg pankuronyum ve 1 mikrogr/kg remifentanil bolus olarak verildi. Anestezi idamesi Grup 1'deki hastalarda (n=20) %2-4 değerinde sevofluran, Grup 2'deki hastalarda (n=20) %1-2 değerinde isofluranla sağlandı. Anestezi indüksiyonundan önce, aortik klemp kaldırıldıktan sonra ve postoperatif periyotta arteriyel kan örnekleri alındı. Bu örneklerde Troponin T, kreatinin kinaz ve kreatinin kinaz MB değerleri ölçüldü. İstatistiksel analizler -iki-yönlü ANOVA ve Mann-Whitney testleri ile yapıldı. Bulgular: Kalp hızı sevofluran grubunda pompa periyodunda, pompadan çıkış sonrası 10. ve 20. dakikalarda anlamlı yüksek bulunmuştur. CKMB düzeyi postoperatif 24. saatte sevofluran grubunda isofluran grubuna göre anlamlı düşüktür. Troponin T kros-klemp kaldırıldıktan sonra (1.015 (0.935-1.850) ng/ml, 1.469 (1.290-1.645) ng/ml, p<0.001) ve postoperatif 24.saatte (5.345±0.654 ng/ml, 8.715±1.020 ng/ml, p<0.001) sevofluran grubunda isofluran grubu ile karşılaştırıldığında anlamlı düşüktür. Sonuç: Miyokardiyal hasarlanma işaretleyicileri olan troponin T ve CKMB düzeylerinin daha düşük düzeylerde saptanması ile sevofluranın isoflurana göre miyokardiyal korumayı daha iyi sağlamakta olduğu kanısındayız. (Anadolu Kardiyol Derg 2011; 11: 257-62) Anahtar kelimeler: Sevofluran, isofluran, miyokardiyal koruma, koroner baypas cerrahisi ABSTRACT Objective: The aim of this prospective randomized study was to compare the myocardial protective effects of sevoflurane and isoflurane during coronary bypass surgery. Methods: After induction of general anesthesia with etomidate 0.3 mg/kg, a bolus dose of pancuronium 0.1 mg/kg and remifentanil 1 mcg/kg was administered. For the maintenance of anesthesia, patients received either sevoflurane (n=20) at 2-4% or isoflurane (n=20) at 1-2%. Arterial blood samples were obtained as follows: before induction of anesthesia, after aortic unclamping, at postoperative period. Troponin-T, creatine kinase (CK), and creatine kinase-MB (CKMB) values were measured in all obtained samples. Statistical analysis was performed using two-way ANOVA analysis and Mann-Whitney test. Results: Heart rate was significantly higher in the sevoflurane group during the aortic side-clamp period, at the 10 th minute and 20 th minute after cardiopulmonary bypass (CPB) ending. The CK-MB values at 24 th postoperative hour in the sevoflurane group were found to be significantly lower from the isoflurane group. The troponin-T values following the removal of the cross-clamp (1.015 (0.935-1.850) ng/ml vs 1.469 (1.290-1.645) ng/ml, p<0.001) and those at the 24 th postoperative hour (5.345±0.654 ng/ml vs 8.715±1.020 ng/ml, p<0.001) were significantly lower in the sevoflurane group when compared to those in the isoflurane group. Conclusion: Sevoflurane provides a better myocardial protection than isof...

Stressful circumstances can cause stomach ulcers, which can bleed, exposing patients to potentially life-threatening complications. In the present animal study, we showed that clonidine, a routinely available medication, may be useful in preventing stress-induced stomach ulcers.