Volatile Anesthetics Reduce Biochemical Markers of Brain Injury and Brain Magnesium Disorders in Patients undergoing Coronary Artery Bypass Graft Surgery

OBJECTIVES:

Neuropsychological disorders are some of the
most common complications of coronary artery bypass graft (CABG)
surgery. The early diagnosis of postoperative brain damage is difficult
and mainly based on the observation of specific brain injury markers.
The aim of this study was to analyze the effects of volatile anesthesia
(VA) on plasma total and ionized arteriovenous magnesium concentrations
in the brain circulation (a-vtMg and a-viMg), plasma matrix
metalloproteinase-9 (MMP-9), and glial fibrillary acidic protein (GFAP)
in adult patients undergoing CABG surgery.

DESIGN:

An observational study.

SETTING:

The Department of Cardiac Surgery in a Medical University Hospital.

PATIENTS AND METHODS:

Studied
parameters were measured during surgery and in the early postoperative
period. Patients were assigned to 3 groups: group O, patients who did
not receive VA; group ISO, patients who received isoflurane; and group
SEV, patients who received sevoflurane.

RESULTS:

Ninety-two
patients were examined. CABG surgery increased MMP-9 and GFAP. The
highest MMP-9, GFAP, and the most dramatic disorders in a-vtMg and
a-viMg were noted in group O.

CONCLUSIONS:

Cardiac
surgery increased plasma MMP-9 and GFAP concentrations. Changes in
MMP-9, GFAP, and arteriovenous tMg and iMg were significantly higher in
group O. Volatile anesthetics, such as ISO or SEV, reduced plasma MMP-9,
GFAP concentrations, and disturbances in a-vtMg and a-viMg.