Influence of multimodal low-opioid anesthesia on the dynamics of аnnexin V in blood plasma during cardiac surgery

Abstract

The aim – to analyze the effect of anesthesia on the dynamics of аnnexin V during coronary artery bypass grafting with сardiopulmonary bypass (CPB), and the dependence of direct clinical results on the expression of аnnexin V. Materials and methods. The study included 30 patients with coronary heart disease who underwent coronary artery bypass grafting with application of 2–3 aortocoronary anastomoses with CPB. According to the anesthetic management, all patients were divided into two groups: the first group (13 patients) – low opioid anesthetic scheme; control group (17 patients) – a standard scheme of anesthetic management. The determination of the level of аnnexin V in the blood was carried out before CPB and after bringing the sternum by enzyme-linked immunosorbent assay. Results. The low-opioid scheme of anesthetic management was associated with significantly (by 1.5 times) lower level of аnnexin V and by 28.38 % lower level of interleukin-6 at the end of the surgery as compared to the standard scheme. A significant negative correlation (r = –0.117, p = 0.523) was found between the levels of аnnexin V and interleukin-6. One-way analysis of variance showed that patients who had low cardiac output syndrome in the postoperative period had a significantly higher level of аnnexin V after CPB (p = 0.001). Conclusions. The use of multimodal low-opioid anesthesia is characterized by relative safety, a sufficient level of analgesia and lower level of аnnexin V compared to the control group. Key words: coronary artery bypass grafting, low-opioid anesthesia, apoptosis, аnnexin V, interleukin-6.