Akademik Veri Yönetim Sistemi
Turk Anesteziyoloji ve Reanimasyon Dernegi Dergisi, cilt.35, sa.6, ss.399-404, 2007 (Scopus, TRDizin)
Aim: The pancreatitis associated protein (PAP) is undetectable in normal pancreatic secretion and overexpressed in the acute phase of pancreatitis. We aimed to investigate the effect of remifentanil infusion and desflurane anesthesia on development of pancreatitis by PAP in open heart surgery. Materials and Methods: 32 patients, ASA grade III scheduled for open heart surgery were included. Anaesthesia was induced with etomidate and vecuronium bromide. Maintenance was made with % 6 Desflurane, % 50 O2 and % 50 N2O in Group I, 1-1.5 μg kg-1 dk-1 remifentanil infusion and % 50 O2 and % 50 N2O in Group II. To assess pancreatic functions of patients before the operation, before, after the cardiopulmonary bypass, after the operation 1st, 2 nd and 7th day PAP, amylase and lipase values were recorded. PAP values lower than 10 μg L-1 were accepted as normal. Friedman, unpaired students t, chi-square, Mann-Whitney U and Wilcoxon tests were used for statistical analysis. Results: Demographic datas were similar in all groups. There were no differences within and between the groups and between the groups regarding amylase, lipase and PAP plasma concentrations. Mesenteric and pancreatic ischemia was not detected in any patients. In Group I use of inotropic agent was significantly higher (p=0.008). Conclusion: Although there were no differences between the groups in pancreatic injury followed by PAP, in desflurane group use of inotropic agent was high. It is shown that, beside routinely used volatile agents, remifentanil can be used safely in open heart surgery without concern of postoperative pancreatitis and hemodynamic instability.