The effects of intrathecal Bupivacaine plus general anesthesia on stress hormones in Coronary Artery Bypass Grafting

Elaheh Peymani Foroushani; Seyyed Kamal Tabatabaei; Zahra Pourmehdi; Mohamad Reza Pipelzadeh; Seyyed Ali Mard

Jentashapir Journal of Cellular and Molecular Biology

Official Journal of Ahvaz Jundishapur University of Medical Sciences

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The effects of intrathecal Bupivacaine plus general anesthesia on stress hormones in Coronary Artery Bypass Grafting

Authors:

Elaheh Peymani Foroushani¹,

Seyyed Kamal Tabatabaei¹,

Zahra Pourmehdi¹,

Mohamad Reza Pipelzadeh¹,

Seyyed Ali Mard^2,*

1Assistant Professor, Department of Cardiac Surgery Anesthesia, Golestan Hospital, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

2Assistant Professor, Department of Physiology, School of Medicine, Research Institute for Infectious Diseases of Digestive System, Physiology Research Center (PRC) Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

Jentashapir Journal of Cellular and Molecular Biology:Vol. 4, issue 5; e94114

Published online:Oct 30, 2013

Article type:Research Article

Received:May 20, 2019

Accepted:Aug 14, 2013

How to Cite:Elaheh Peymani ForoushaniSeyyed Kamal TabatabaeiZahra PourmehdiMohamad Reza PipelzadehSeyyed Ali MardThe effects of intrathecal Bupivacaine plus general anesthesia on stress hormones in Coronary Artery Bypass Grafting.4(5):e94114.

Abstract

Background: Activation of stress response during cardiac surgeries such as cardiopulmonary bypass (CPB) can increase myocardial oxygen demand and consumption through induced tachycardia and augmented peripheral vascular resistance. These physiologic consequences may lead to increased morbidity and mortality by putting too great a strain on the already compromised organ systems.

Materials and Methods: This controlled trial study was conducted to evaluate the effect of intrathecal bupivacaine plus general anesthesia on stress response in patients undergoing open heart surgery. Methods In this case, thirty patients undergoing open heart surgery were randomly assigned to receive either intravenous opioid [control group (n=15)] or intravenous opioid plus intrathecal bupivacaine [ITB group (n=15)]. Arterial blood samples were obtained from each patient at five predetermined times to measure plasma levels of norepinephrine and epinephrine and cortisol including: Immediately prior to spinal anesthesia; 5 min after sternotomy; 30 min after initiation of cardiopulmonary bypass (CPB); 30 min after separation from CPB; and 4 hours after separation from CPB.

Results: Administration of intrathecal bupivacaine plus general anesthesia significantly decreased plasma levels of cortisol, adrenalin and noradrenaline in treatment group as compared with control group at 5 min after sternotomy and 30 min after CPB starting and 4 hour after CPB ending, respectively.

Conclusion: the findings showed the application of intrathecal bupivacaine to patients undergoing open heart surgery significantly decreases plasma levels of stress hormones.

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