Rajesh Kumar Kodalli, Ayya Syama Sundar, Mahesh Vakamudi, Harish Ravulapali, Sushma Nandipati, Nivash Chandrasekaran, Ranjith Baskar Karthekeyan
Department of Cardiac Anesthesiology, Sri Ramachandra Medical College and Research Institute, Porur, Chennai,Tamil Nadu, India
Aims and Objective: We tested the hypothesis that use of levosimendan would be associated with better perioperative hemodynamics and cardiac function during off-pump coronary artery bypass grafting (OPCAB) in patients with good left ventricular function. Materials and Methods: Thirty patients scheduled for OPCAB were randomized in a double-blind manner to receive either levosimendan 0.1 μg/kg/min or placebo after induction of general anesthesia. The hemodynamic variables were measured after induction of anesthesia, at 6 minute after application of tissue stabilizer for the anastomoses of left anterior descending artery, diagonal artery, left circumflex artery, and right coronary artery and at 6, 12, 18, and 24 hours after completion of surgery. Results: Compared with placebo group, cardiac index (CI) was significantly higher and systemic vascular resistance index (SVRI) was significantly lower at 6, 12, 18, and 24 hour after surgery in levosimendan group. Norepinephrine was infused in 60% of the patients in the levosimendan group compared to 6.7% in the control group ( P < 0.05). Lactate and mixed venous oxygen saturation were not significantly different between groups. Conclusions: Levosimendan significantly increased CI and decreased SVRI after OPCAB but it did not show any outcome benefit in terms of duration of ventilation and intensive care unit stay.
Ranjith Baskar Karthekeyan
Department of Cardiac Anesthesiology, SRMC and RI, Porur, Chennai
Source of Support: None, Conflict of Interest: None
[FULL TEXT] [PDF]*