Effects of propofol on cerebral oxygenation during cardiopulmonary bypass in children

Purpose: Neurologic complications occur following cardiopulmonary bypass su rgery, We conducted a randomized, controlled, single-blind study to determi ne the effect of propofol on the redox status of cytaa(3), and to evaluate its potential for decreasing neurologic complications, Methods and Materials: Twenty-four children (median age: 3.3 yr; median wei ght: 14.4 kg) scheduled for elective cardiopulmonary bypass surgery were as signed to either the experimental group (Group Fl given sufficient propofol to eliminate brain electrical activity as measured on EEG (i.e, burst supp ression)) or the control group (Group C, no propofol). Near infrared spectr oscopy data were collected at one-second intervals throughout the surgical procedures. Pre- and postoperative neurologic examinations were completed b y a physician blinded to the group to which the patient was assigned. Chang e in cytochrome aa, data at 10-min intervals (10, 20, 30, 40 min) following start of bypass were compared between groups by repeated measures analysis of variance, Results: The patterns of change in redox stale of cytochrome were different between the two groups (P < 0.002). The pattern of change within Group P w as similar to that in hypothermic patients in Group C, There were correlati ons between change in cytaa(3) redox status and temperature in the control subjects. There were no gross neurologic complications in either group, Conclusions: Propofol appears to stabilize the energy supply/demand equilib rium of the brain during cardiopulmonary bypass surgery and thus theoretica lly could reduce the incidence or severity of neurologic complications.