Cardioprotective Properties of Sevoflurane in Patients Undergoing Coronary Surgery with Cardiopulmonary Bypass Are Related to the Modalities of Its Administration

Sevoflurane anesthesia did not affect postoperative cognitive dysfunction in patients undergoing coronary artery bypass graft surgery

“…Finally, the anesthetic regime used may have had some effects on our result. De Hert et al [10] showed that sevofl urane has differential protective effects on cardiac function. Further studies using standardized techniques would be of benefi t to determine the relationship between postoperative cognitive dysfunction and the use of sevofl urane in patients undergoing CABG surgery.…”

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after cardiopulmonary bypass (CPB) has been reported in as many as 79% of patients during the early postoperative period [2][3][4][5].Several proposed techniques have been considered for neuroprotection during surgery, including the use of beta-blockers to prevent postoperative atrial fi brillation [6], increasing the level of Immunoglobulin M (IgM) anti-endotoxin core antibody [7], avoiding CPB, and strictly controlling plasma glucose levels during the perioperative period [8].Many animal studies have shown that volatile anesthetics, such as sevofl urane or isofl urane, have a preconditioning effect [9][10][11][12][13]. In addition, there have been several clinical studies regarding the effects of preadministration of volatile anesthetics, such as sevofl urane or isofl urane, on the heart during cardiac surgery.

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“…In addition, there have been several clinical studies regarding the effects of preadministration of volatile anesthetics, such as sevofl urane or isofl urane, on the heart during cardiac surgery. For example, De Hert et al [10] reported that sevofl urane reduced the elevation of postoperative troponin concentration compared with that in the propofol group. In contrast, there have been no clinical studies regarding the effects of volatile anesthetics on neuroprotection during cardiac surgery.…”

“…Many animal studies have shown that volatile anesthetics, such as sevofl urane or isofl urane, have a preconditioning effect [9][10][11][12][13]. In addition, there have been several clinical studies regarding the effects of preadministration of volatile anesthetics, such as sevofl urane or isofl urane, on the heart during cardiac surgery.…”

The ageing population – a challenge for cardiovascular surgery

“…The use of cervical peridural anaesthesia (PDA) additionally to conventional inhalative regimens to block postoperative pain and consecutively improve respiratory capacity has become a valuable tool to reduce postoperative ventilation and ICU time and might be attractive in patients with COPD [22]. New drugs such as sevoflourane have been shown to have cardioprotective effects and have replaced in most operation theatres other forms of anaesthesia [23].…”