Korean J Anesthesiol.  2005 Mar;48(3):274-281. 10.4097/kjae.2005.48.3.274.

Preventive Effect of Conduit Vessel Spasm after Coronary Artery Bypass Grafting Surgery

• Lee YC
• Jang YH
• Yoo JG
• Kim JM
• Park NH
• Choi SY

• KMID: 2091975
• DOI: http://doi.org/10.4097/kjae.2005.48.3.274

Abstract

BACKGROUND: Use of radial artery (RA) for coronary artery bypass grafting (CABG) is an increasingly common practice. The objective of our study was to compare the effects of two drugs as antispastic agents in patients undergoing CABG.
METHODS
Sixty patients, submitting to CABG using the RA, were randomly assigned to two treatment groups (n = 30 in each group). Following the induction of anesthesia, the two groups were administered either 0.2-2microgram/kg/min nitroglycerin or 0.05-0.1 mg/kg/hr diltiazem as a continuous IV infusion. CABG in both groups was performed as per standard surgical protocol.
RESULTS
The peak serum creatinine phosphokinase-MB level (59.3 ng/ml for nitroglycerin treatment versus 57.7 ng/ml for diltiazem treatment), postoperative ejection fraction (52.3% versus 48.4%), duration of stay in the ICU and total length of hospital stay were not significantly different between the groups (P > 0.05). However, the need for inotropic agents to prevent or treat intraoperative hypotension was less for patients in the nitroglycerin group than for patients in the diltiazem group (60.0% to 83.3%).
CONCLUSIONS
Our results indicate that nitroglycerin is superior to diltiazem as an antispastic agent. We suggest that nitroglycerin should be the agent for choice for the prevention of conduit RA spasm.

Keyword

coronary artery; diltiazem; nitroglycerin; spasm

MeSH Terms

Anesthesia
Coronary Artery Bypass*
Coronary Vessels*
Creatinine
Diltiazem
Humans
Hypotension
Length of Stay
Nitroglycerin
Radial Artery
Spasm*
Creatinine
Diltiazem
Nitroglycerin