Comparison of the Effects of Propofol Anaesthesia and Desflurane Anaesthesia on Neutrophil/Lymphocyte Ratios After Coronary Artery Bypass Surgery

Öz

Objective: Coronary artery bypass surgery with cardiopulmonary bypass can induce postoperative systemic leukocytic alterations including leukocytosis, neutrophilia, or lymphopenia. The present study aims to compare the effects of propofol and desflurane anaesthesia on the leukocytic alterations including neutrophil-to-lymphocyte ratios after coronary artery bypass surgery.

Materials and Methods: Sixty patients scheduled for coronary artery bypass surgery were randomly assigned into two groups: group P (n=30), which were anaesthesised with propofol (intravenous anaesthesia) and group D, which were anaesthesised with desflurane (inhalational anesthesia). Differential counts of leukocytes with neutrophil/lymphocyte ratios of peripheral blood were obtained just before anaesthesia induction (for basal values), at the postoperative 12th, 24th, and 48th hours.

Results: At the postoperative 12th decrease in lymphocyte counts in group P was significantly lower than in group D (1.23 ± 0.81, 0.92 ± 1.01, respectively, with a p value of <0.001). Depending on this difference, neutrophil/lymphocyte ratios in group P were lower than in group D, which was statistically significant (11.21 ± 5.01, 22.81 ± 15.24, respectively, with a p value of <0.001). At postoperative 48th hour, it was seen that the statistically significant difference between groups on the basis of lymphocyte counts and neutrophil/lymphocyte ratios dissapeared. But a statistically significant difference appeared between the two groups on the basis of neutrophil counts (in group P 6.57 ± 2.05, in group D 10.20 ± 5.26; p<0.001)

Conclusion: Comparing with desflurane anaesthesia, propofol anaesthesia favorably but transiently modifies leukocytic alterations, including neutrophil-to-lymphocyte ratios in peripheral blood during postoperative period of coronary artery bypass surgery.

Key Words: Coronary Artery Surgery; Propofol And Desflurane Anesthesia; Neutrophil/Lymphocyte Ratio.

Anahtar Kelimeler

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Journal of Turgut Ozal Medical Center

Öz

Amaç: Kardiyopulmoner by-pass ile yapılan koroner arter by-pass cerrahisi lökositoz, nötrofili ve lenfopeniyi de içeren postoperatif lökosit dağılımı değişikliklerini başlatabilir. Bu çalışma ile kardiyopulmoner bypass kullanılarak koroner by-pass cerrahisine giden hastalarda propofol (intravenöz) ve desfluran (inhalasyon) anestezisinin postoperatif lökositik değişiklikler ve nötrofil/ lenfosit oranı üzerine etkileri incelenmiştir.Gereç ve Yöntemler: Bu prospektif randomize çalışmada elektif koroner arter by-pass cerrahisi planlanan 60 hasta iki eşit gruba randomize edildi. olgulardan 30’unda (grup P, n=30) propofol (intravenöz) anestezi ve diğer 30’unda ise (grup D, n=30) desfluran (inhalasyon anestezisi kullanıldı. Hastalardan lökosit alt tipleri ve nötrofil/lenfosit oranı tayini için anestezi indüksiyonundan hemen önce (bazal değer), postoperatif 12. saat, 24. saat ve 48. saatlerde olmak üzere periferik venden kan örneği alındı. Bulgular: Postoperatif 12.saat kan sayımlarında lenfosit sayısındaki düşüş grup P’de grup D’ye göre daha az belirgin (sırasıyla 1.23 ± 0.81, 0.92 ± 1.01 ve p değeri

Anahtar Kelimeler

• Koroner By-Pass Cerrahisi, Propofol Ve Desfluran Anestezisi, Nötrofil/Lenfosit Oranı

Kaynakça

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