Objectives:The aim of this study is to compare the effects of propofol and isoflurane, both supplemented with sufentanil, on the stress response in coronary artery bypass grafting surgery with cardiopulmonary bypass, using cortisol as a biochemical marker
Design: This double-blind randomized clinical trial will conduct on patients who undergo CABG surgery after obtaining the informed consent and approved by the Institutional Ethics Committee of Guilan University of Medical Science.
Setting and Conduct: Because of maximum cortisol level occurs in early morning , All samples will take on the morning between 7:30 am to 8:30 am.
Participants:
Inclusion criteria:
72 patients classified upscale 65-18 year old, physical status (ASA class) II-III, in year between 2014-2015 ,who underwent elective bypass surgery after coronary artery disease (3 vessels) with cardiopulmonary pump will enroll in the study .
In any case of following problem the patients don’t meet the inclusion criteria, they don’t enter into study: emergency surgery, liver-kidney disease, neurology, diabetes, thyroid, use of corticosteroids and other drugs that suppress the immune , obesity (BMI≥30), addiction to alcohol and drugs.
Exclusion criteria:
Any complication during surgery, bleeding, arrhythmia resistant to conventional treatment, duration of contact pump over 100 minutes, hematocrit less than 25%, intubation prolonged intensive care unit, drug use( sympathomimetic) to disconnect the patient from the pump (epinephrine, norepinephrine) and the use of IABP patients were excluded from the study.
Intervention: This study will perform in double blind setting and the patients will randomly allocate to select the cards I (isoflurane group) or cart P (propofol group) to receive( isoflorane-sufentanil ) or (Propofol-sufentanil).
outcome variable :Levels of blood cortisol will measure half an hour before transfer to the operating room and given premedication (T0), after heart-lung pump (T1) and 24 hours after the surgery (T2).