Skip to main content

Advertisement

SpringerLink
Log in

Protective Effect of Propofol and Its Relation to Postoperation Recovery in Children Undergoing Cardiac Surgery with Cardiopulmonary Bypass

  • Original Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

The aim of this study was to investigate the effect of propofol and its relation to postoperation recovery in children undergoing cardiac surgery with cardiopulmonary bypass (CPB). Twenty ASA class I–II children with congenital heart disease undergoing cardiac surgery were randomly allocated to a propofol group (n = 10) or a control group (n = 10). Blood samples were collected at five time points: before operation (T 0), before the start of CPB (T 1), 25 min after the aorta was cross-clamped (T 2), 30 min after release of the aortic cross-clamp (T 3), and 2 h after the cessation of CPB (T 4). The myocardial samples were collected at the time of incubation into the right atrium before CPB and at 30 min after reperfusion. After CPB, propofol significantly suppressed the increase of the serum lactate dehydrogenase (LDH), creatine phosphokinase (CK), and interleukin-6 (IL-6) levels and the decrease of the serum superoxide dismutase (SOD) level. In addition, propofol inhibited the increase of myocardial nuclear factor-κB (NF-κB) expression and inflammatory cells infiltration after CPB. Furthermore, propofol significantly shortened the tracheal extubation time. In conclusion, propofol exerts a protective effect and improves postoperation recovery through its antioxidant and anti-inflammatory actions in children undergoing cardiac surgery with CPB.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Altavilla D, Deodato B, Campo GM, Arlotta M, Miano M, Squadrito G et al (2000) IRFI 042, a novel dual vitamin E-like antioxidant, inhibits activation of nuclear factor-kappaB and reduces the inflammatory response in myocardial ischemia-reperfusion injury. Cardiovasc Res 47:515–528

    Article  PubMed  CAS  Google Scholar 

  2. An K, Shu H, Huang W, Huang X, Xu M, Yang L et al (2008) Effects of propofol on pulmonary inflammatory response and dysfunction induced by cardiopulmonary bypass. Anaesthesia 63:1187–1192

    Article  PubMed  CAS  Google Scholar 

  3. Cavalca V, Colli S, Veglia F, Eligini S, Zingaro L, Squellerio I et al (2008) Anesthetic propofol enhances plasma gamma-tocopherol levels in patients undergoing cardiac surgery. Anesthesiology 108:988–997

    Article  PubMed  CAS  Google Scholar 

  4. Corcoran TB, Engel A, Sakamoto H, O’Callaghan-Enright S, O’Donnell A, Heffron JA et al (2004) The effects of propofol on lipid peroxidation and inflammatory response in elective coronary artery bypass grafting. J Cardiothorac Vasc Anesth 18:592–604

    Article  PubMed  CAS  Google Scholar 

  5. Corcoran TB, Engel A, Sakamoto H, O’Shea A, O’Callaghan-Enright S, Shorten GD (2006) The effects of propofol on neutrophil function, lipid peroxidation and inflammatory response during elective coronary artery bypass grafting in patients with impaired ventricular function. Br J Anaesth 97:825–831

    Article  PubMed  CAS  Google Scholar 

  6. Evans ZP, Mandavilli BS, Ellett JD, Rodwell D, Fariss MW, Fiorini RN et al (2009) Vitamin E succinate enhances steatotic liver energy status and prevents oxidative damage following ischemia/reperfusion. Transplant Proc 41:4094–4098

    Article  PubMed  CAS  Google Scholar 

  7. Fan H, Sun B, Gu Q, Lafond-Walker A, Cao S, Becker LC (2002) Oxygen radicals trigger activation of NF-kappaB and AP-1 and upregulation of ICAM-1 in reperfused canine heart. Am J Physiol Heart Circ Physiol 282:H1778–H1786

    PubMed  CAS  Google Scholar 

  8. Ji L, Fu F, Zhang L, Liu W, Cai X, Zhang L et al (2010) Insulin attenuates myocardial ischemia/reperfusion injury via reducing oxidative/nitrative stress. Am J Physiol Endocrinol Metab 298:E871–E880

    Article  PubMed  CAS  Google Scholar 

  9. Kokita N, Hara A, Abiko Y, Arakawa J, Hashizume H, Namiki A (1998) Propofol improves functional and metabolic recovery in ischemic reperfused isolated rat hearts. Anesth Analg 86:252–258

    PubMed  CAS  Google Scholar 

  10. Kukielka GL, Hawkins HK, Michael L, Manning AM, Youker K, Lane C et al (1993) Regulation of intercellular adhesion molecule-1 (ICAM-1) in ischemic and reperfused canine myocardium. J Clin Investig 92:1504–1516

    Article  PubMed  CAS  Google Scholar 

  11. Levonen AL, Vähäkangas E, Koponen JK, Ylä-Herttuala S (2008) Antioxidant gene therapy for cardiovascular disease: current status and future perspectives. Circulation 117:2142–2150

    Article  PubMed  CAS  Google Scholar 

  12. Murphy GJ, Angelini GD (2004) Side effects of cardiopulmonary bypass: What is the reality? J Card Surg 19:481–488

    Article  PubMed  CAS  Google Scholar 

  13. Nelson SK, Bose S, Rizeq M, McCord JM (2005) Oxidative stress in organ preservation: a multifaceted approach to cardioplegia. Biomed Pharmacother 59:149–157

    Article  PubMed  CAS  Google Scholar 

  14. Shin IW, Jang IS, Lee SH, Baik JS, Park KE, Sohn JT et al (2010) Propofol has delayed myocardial protective effects after a regional ischemia/reperfusion injury in an in vivo rat heart model. Korean J Anesthesiol 58:378–382

    Article  PubMed  CAS  Google Scholar 

  15. Suleiman MS, Zacharowski K, Angelini GD (2008) Inflammatory response and cardioprotection during open-heart surgery: the importance of anaesthetics. Br J Pharmacol 153:21–33

    Article  PubMed  CAS  Google Scholar 

  16. Toledo-Pereyra LH, Lopez-Neblina F, Toledo AH (2004) Reactive oxygen species and molecular biology of ischemia/reperfusion. Ann Transplant 9:81–83

    PubMed  CAS  Google Scholar 

  17. Wang B, Shravah J, Luo H, Raedschelders K, Chen DD, Ansley DM (2009) Propofol protects against hydrogen peroxide-induced injury in cardiac H9c2 cells via Akt activation and Bcl-2 up-regulation. Biochem Biophys Res Commun 389:105–111

    Article  PubMed  CAS  Google Scholar 

  18. Xia Z, Godin DV, Chang TK, Ansley DM (2003) Dose-dependent protection of cardiac function by propofol during ischemia and early reperfusion in rats: effects on 15-F2t-isoprostane formation. Can J Physiol Pharmacol 81:14–21

    Article  PubMed  CAS  Google Scholar 

  19. Xia Z, Huang Z, Ansley DM (2006) Large-dose propofol during cardiopulmonary bypass decreases biochemical markers of myocardial injury in coronary surgery patients: a comparison with isoflurane. Anesth Analg 103:527–532

    Article  PubMed  CAS  Google Scholar 

  20. Xia WF, Liu Y, Zhou QS, Tang QZ, Zou HD (2011) Comparison of the effects of propofol and midazolam on inflammation and oxidase stress in children with congenital heart disease undergoing cardiac surgery. Yonsei Med J 52:326–332

    Article  PubMed  CAS  Google Scholar 

  21. Xu JH, Zhao YY, Wang JK, Yuan ZG, Zhang TZ (2010) Effects of mouse recombinant bone morphogenetic protein-7 transfection on cell apoptosis, NF-kappaB, and downstream genes in cultured primary cardiomyocytes after simulated ischemia and reperfusion injury. J Cardiovasc Pharmacol 56:69–77

    Article  PubMed  CAS  Google Scholar 

  22. Zhang SH, Wang SY, Yao SL (2004) Antioxidative effect of propofol during cardiopulmonary bypass in adults. Acta Pharmacol Sin 25:334–340

    PubMed  Google Scholar 

  23. Zheng JH, Gao BT, Jiang ZM, Yu XQ, Xu ZW (2010) Evaluation of early macrophage activation and NF-kappaB activity in pulmonary injury caused by deep hypothermia circulatory arrest: an experimental study. Pediatr Cardiol 31:215–221

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

This work was supported by a grant from scientific and technological project of Hubei Province of China (No. 301140525).

Author information

Authors and Affiliations

  1. Departments of Critic Care Medicine and Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China

    Wen-fang Xia

  2. Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China

    Yu Liu & Qi-zhu Tang

  3. Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People’s Republic of China

    Yu Liu & Qi-zhu Tang

  4. Department of Critic Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China

    Qing-shan Zhou & Han-dong Zou

Authors
  1. Wen-fang Xia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yu Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Qing-shan Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Qi-zhu Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Han-dong Zou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Qing-shan Zhou.

Additional information

W. Xia and Y. Liu contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Xia, Wf., Liu, Y., Zhou, Qs. et al. Protective Effect of Propofol and Its Relation to Postoperation Recovery in Children Undergoing Cardiac Surgery with Cardiopulmonary Bypass. Pediatr Cardiol 32, 940–946 (2011). https://doi.org/10.1007/s00246-011-0018-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-011-0018-5

Keywords

Search

Navigation