Exploration of xenon as a potential cardiostable sedative: a comparison with propofol after cardiac surgery

Abstract

SummaryXenon anaesthesia is thought to have minimal haemodynamic side-effects. It is, however, expensive and requires special delivery systems for economic use. In this randomised cross-over study, we: (i) investigated the haemodynamic profile and recovery characteristics of xenon compared with propofol sedation in postoperative cardiac surgery patients, and (ii) evaluated a fully closed breathing system to minimise xenon consumption. We demonstrated a significantly faster recovery from xenon (3 min 11 s) than propofol sedation (25 min 23 s). Relative to propofol, xenon sedation produced no change in heart rate or mean arterial pressure and there were significantly higher mean values for central venous pressure (10.6 vs. 8.9 mmHg), pulmonary artery occlusion pressure (11.2 vs. 9.5 mmHg), mean pulmonary artery pressure (20.1 vs. 18.3 mmHg) and systemic vascular resistance index (2170 vs. 1896 dyn.s.cm 25 .m 22 ). The haemodynamic profile seen with propofol reflected its known vasodilator effects. This was supported by the almost identical left ventricular stroke work indexes seen with both methods of sedation.

Cooling Combined with Immediate or Delayed Xenon Inhalation Provides Equivalent Long-Term Neuroprotection after Neonatal Hypoxia—Ischemia

“…Xenon is also attractive in this role because of its lack of chemical reactivity and lack of clinical side effects (Dingley et al, 2001;Marx et al, 1997;Preckel et al, 2004;Rossaint et al, 2003), rapid reversibility, and lack of fetotoxicity (Burov et al, 2002;Lane et al, 1980). A radioisotope of Xe (Xe 133 ) has been used in neonates by injecting Xe 133 dissolved in 1 ml of water and counting the distribution of radioactivity as a measure of blood flow.…”

Cardiovascular effects of xenon and nitrous oxide in patients during fentanyl‐midazolam anaesthesia*

“…To the best of our knowledge, no studies have examined the effects of anaesthetic concentrations of xenon in patients with known cardiac disease. Because previous studies have revealed minimal cardiovascular effects of xenon [3,9,10], we hypothesised that xenon at an anaesthetic concentration would provide haemodynamic stability in patients with ischaemic heart disease. Therefore, we compared the haemodynamic effects of 60% xenon and N 2 O using a TOE and a pulmonary artery catheter in patients due to undergo coronary artery bypass graft (CABG) surgery.…”

“…One study was performed in healthy surgical patients [3]. In two other studies performed by the same investigators [9,10], xenon was used at an average concentration of only 27-28% to produce sedation but not anaesthesia (the minimum alveolar concentration [MAC] of xenon is 71% [11]). To the best of our knowledge, no studies have examined the effects of anaesthetic concentrations of xenon in patients with known cardiac disease.…”

Xenon and Hypothermia Combine Additively, Offering Long-Term Functional and Histopathologic Neuroprotection After Neonatal Hypoxia/Ischemia

“…Xenon, a noble gas with anesthetic properties, has shown great promise as a neuroprotectant in both in vitro and in vivo experimental studies. 14 -20 It is attractive as a combination therapy with hypothermia owing to its lack of chemical reactivity, lack of clinical side effects, [21][22][23][24] previous use in neonates, 25 rapid reversibility, and lack of fetotoxicity. 26,27 Furthermore, xenon was approved as an anesthetic drug in Russia in 2002, 28 in Germany in 2005, and extended through Europe in March 2007.…”