Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Anesthesiology, ARTERY-BYPASS SURGERY, DECREASES BIOCHEMICAL MARKERS, PRESERVES MYOCARDIAL-FUNCTION, CARDIOPULMONARY BYPASS, CARDIAC-SURGERY, GRAFT-SURGERY, TROPONIN-I, SEVOFLURANE, PROTECTION, PROPOFOL, Aged, Anesthetics, Inhalation, Anesthetics, Intravenous, Cardiopulmonary Bypass, Cardiotonic Agents, Coronary Artery Bypass, Desflurane, Female, Humans, Ischemic Preconditioning, Myocardial, Isoflurane, Length of Stay, Male, Methyl Ethers, Middle Aged, Myocardial Reperfusion Injury, Postoperative Complications, Risk Factors, Sevoflurane, Survival Analysis, Troponin T, 1103 Clinical Sciences, 1109 Neurosciences, 3202 Clinical sciences, 3203 Dentistry

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.