Premium
Effect of N ‐acetylcysteine on cardiac injury and oxidative stress after abdominal aortic aneurysm repair: A randomized controlled trial
Author(s) -
MAHMOUD K. M.,
AMMAR A. S.
Publication year - 2011
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2011.02492.x
Subject(s) - medicine , malondialdehyde , abdominal aortic aneurysm , abdominal surgery , anesthesia , acetylcysteine , oxidative stress , placebo , cardiac surgery , troponin i , surgery , gastroenterology , antioxidant , myocardial infarction , aneurysm , pathology , biochemistry , chemistry , alternative medicine
Background Several studies have reported that the antioxidant properties of N ‐acetylcysteine ( NAC ) can provide cardiac protection through scavenging of free radicals. The present study was aimed to assess the efficacy of NAC for cardiac protection in patients undergoing elective abdominal aortic aneurysm ( AAA ) repair. Methods Fifty adult patients undergoing ( AAA ) repair were randomly allocated to receive NAC infusion ( n = 25) or placebo infusion ( n = 25). NAC infusion in group I ( NAC group) was started at a rate of 0.3 mg/kg/min intravenously during surgery then decreased to a rate of 0.2 mg/kg/min for 24 h post‐operatively. Group II (placebo group) received an equivalent rate of placebo infusion. The following parameters: myocardial‐specific protein troponin‐ I , creatine phosphokinase‐MB ( CPK ‐ MB ), plasma pro‐inflammatory cytokines [tumour necrosis factor‐α ( TNF ‐α) and interleukin ( IL )‐1β], were assessed at the following time points: preoperatively and at 1 h, 12 h, 24 h, 48 h, and 96 h after surgery. Furthermore, serum malondialdehyde ( MDA ) and total antioxidant capacity ( TAC ) were measured preoperatively as a baseline, during aortic clamping, 30 min after declamping, at the end of surgery, 2 h after surgery, 12 h after surgery, and 24 h after surgery. Results NAC infusion patients had significantly lower post‐operative concentrations of myocardial‐specific protein [ cTnI , CPK ‐ MB ] and pro‐inflammatory cytokines [ TNF ‐α, IL ‐1β]. In addition, MDA level was less and TAC was higher in patients who received NAC infusion. Conclusion NAC infusion provided cardiac protection through scavenging of oxygen free radicals.