A comparison of volatile and non volatile agents for cardioprotection during on-pump coronary surgery

Anaesthesia. 2009 Sep;64(9):953-60. doi: 10.1111/j.1365-2044.2009.06008.x.

Abstract

A randomised study of 414 patients undergoing coronary artery surgery with cardiopulmonary bypass was conducted to compare the effects of a volatile anaesthetic regimen with either deesflurane or sevoflurane, and a total intravenous anaesthesia (TIVA) regimen on postoperative troponin T release. The primary outcome variable was postoperative troponin T release, secondary outcome variables were hospital length of stay and 1-year mortality. Maximal postoperative troponin T values did not differ between groups (TIVA: 0.30 [0.00-4.79] ng x ml(-1) (median [range]), sevoflurane: 0.33 [0.02-3.68] ng x ml(-1), and desflurane: 0.39 [0.08-3.74] ng x ml(-1)). The independent predictors of hospital length of stay were the EuroSCORE (p < 0.001), female gender (p = 0.042) and the group assignment (p < 0.001). The one-year mortality was 12.3% in the TIVA group, 3.3% in the sevoflurane group, and 6.7% in the desflurane group. The EuroSCORE (p = 0.003) was the only significant independent predictor of 1-year mortality.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anesthetics, Inhalation / therapeutic use*
  • Anesthetics, Intravenous / therapeutic use*
  • Cardiopulmonary Bypass
  • Cardiotonic Agents / therapeutic use*
  • Coronary Artery Bypass / methods*
  • Desflurane
  • Female
  • Humans
  • Ischemic Preconditioning, Myocardial / methods
  • Isoflurane / analogs & derivatives
  • Isoflurane / therapeutic use
  • Length of Stay
  • Male
  • Methyl Ethers / therapeutic use
  • Middle Aged
  • Myocardial Reperfusion Injury / blood
  • Myocardial Reperfusion Injury / prevention & control*
  • Postoperative Complications / prevention & control
  • Risk Factors
  • Sevoflurane
  • Survival Analysis
  • Troponin T / blood

Substances

  • Anesthetics, Inhalation
  • Anesthetics, Intravenous
  • Cardiotonic Agents
  • Methyl Ethers
  • Troponin T
  • Sevoflurane
  • Desflurane
  • Isoflurane