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.