[Clinical evaluation of prophylactic nitroglycerin infusion during coronary artery bypass grafting].

We evaluated retrospectively the benefit of prophylactic nitroglycerin (TNG) infusions during elective coronary artery bypass grafting (CABG) in 73 patients. In all patients anesthesia was maintained with high dose fentanyl. Thirty-seven patients were infused TNG 0.3 microgram.kg-1.min-1 during surgery and 36 patients were not. The TNG-infused patients demonstrated lower perfusion pressure during cardiopulmonary bypass (CPB) and higher incidence of inotropic administrations than the uninfused patients. Serum myocardial creatine phosphokinase (CPK-MB) levels of TNG-infused patients were higher than those of TNG-uninfused patients on the first postoperative day. We speculate that inotropic administrations under low myocardial perfusion pressure at the time of weaning from CPB induces myocardial ischemia which in turn causes an increase in serum CPK-MB level. We conclude that prophylactic administration of TNG does not prevent perioperative ischemia during CABG.