Research Article Comparison of TIVA and Desflurane Added to a Subanaesthetic Dose of Propofol in Patients Undergoing Coronary Artery Bypass Surgery: Evaluation of Haemodynamic and Stress Hormone Changes Didem Onk, 1 Tülin Akarsu AyazoLlu, 2 Oruç Alper Onk, 3 Mehmet Aksüt, 4 Murat Günay, 5 Kultigin Turkmen, 6 Aynur Özensoy, 7 ÇiLdem YazJcJ Ersoy, 8 and Abdulkadir Çoban 5 1 Department of Anesthesiology, Erzincan University, 24030 Erzincan, Turkey 2 Department of Anesthesiology, G¨ oztepe Training and Research Hospital, 34722 Istanbul, Turkey 3 Department of Cardiovascular Surgery, Erzincan University, 24030 Erzincan, Turkey 4 Department of Cardiovascular Surgery, Kartal Kos ¸uyolu High Specialization Training and Research Hospital, 34865 Istanbul, Turkey 5 Department of Biochemistry, Erzincan University, 24030 Erzincan, Turkey 6 Department of Internal Medicine, Division of Nephrology, Necmettin Erbakan University, Meram School of Medicine, 42080 Konya, Turkey 7 Department of Anesthesiology, Kartal Kos ¸uyolu High Specialization Training and Research Hospital, 34865 Istanbul, Turkey 8 Department of Internal Medicine, S ¸is ¸li Etfal Training and Research Hospital, 34363 Istanbul, Turkey Correspondence should be addressed to Didem Onk; d.hesapdar@gmail.com Received 29 January 2016; Revised 2 June 2016; Accepted 7 June 2016 Academic Editor: Teodoros Xanthos Copyright © 2016 Didem Onk et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. Increased levels of stress hormones are associated with mortality in patients undergoing coronary artery bypass grafing (CABG). Aim. To compare total intravenous anaesthesia (TIVA) and desfurane added to a subanaesthetic dose of propofol. Material and Methods. Fify patients were enrolled in this study. Fentanyl (3–5 mcg/kg/h) was started in both groups. Patients were divided into two groups. Te PD group ( = 25) received 1 minimum alveolar concentration (MAC) desfurane anaesthesia in addition to propofol infusion (2-3 mg/kg/h), while P group ( = 25) received propofol infusion (5-6 mg/kg/h) only. Biochemical data, cortisol, and insulin levels were measured preoperatively (T0), afer initiation of CPB but before cross-clamping the aorta (T1), afer removal of the cross-clamp (T2), and at the 24th postoperative hour (T3). Results. Systolic, diastolic, and mean arterial pressure levels were signifcantly higher in PD group than those in P group in T1 and T2 measurements ( ≤ 0.05). CK-MB showed a signifcant decrease in group P ( ≤ 0.05). When we compared both groups, cortisol levels were signifcantly higher in PD group than P group ( ≤ 0.05). Conclusion. Stress and haemodynamic responses were better controlled using TIVA than desfurane inhalation added to a subanaesthetic dose of propofol in patients undergoing CABG. 1. Introduction A stress response is defned as the hormonal and metabolic changes that occur following injury and trauma [1]. Cortisol is secreted in response to stimulation of the adrenal cortex, which occurs from increasing adrenocorticotrophic hor- mone (ACTH) levels afer initiation of surgical procedures. As a result of the physiological consequences of car- diopulmonary bypass (CPB), hormone secretion and blood glucose levels change and these alterations render the patients undergoing cardiac surgery vulnerable to morbidities includ- ing infection, atrial fbrillation, low cardiac output, prolonged respiratory depression, and cerebrovascular accident [2–4]. Recognition of the fact that anaesthetic agents have an important role in the stress response led to several studies that focused on inhibition and prevention of the stress response [5]. In studies of the efect of stress response inhibition on Hindawi Publishing Corporation BioMed Research International Volume 2016, Article ID 3272530, 6 pages http://dx.doi.org/10.1155/2016/3272530