Myocardial protection during off pump coronary artery bypass surgery: A comparison of inhalational anesthesia with sevoflurane or desflurane and total intravenous anesthesia

Abstract

The study did not reveal any difference in myocardial protection after OPCAB with either sevoflurane or desflurane or TIVA using propofol as assessed by measuring serial cTnT values.

Comparison of the myocardial protective effect of sevoflurane versus propofol in patients undergoing heart valve replacement surgery with cardiopulmonary bypass

“…Nevertheless, most of those studies were performed in patients undergoing coronary artery bypass grafting (CABG), while few studies in non-CABG patients. Furthermore, high quality meta-analyses in adult cases have showed controversial or contradicting results [10–15]. In this study, we compared the cardioprotective effect of anesthesia with intravenous propofol and inhaled sevoflurane in patients undergoing mitral, aortic or tricuspid valve replacement surgery.…”

Comparison of haemodynamics and myocardial injury markers under desflurane vs. propofol anaesthesia for off-pump coronary surgery. A prospective randomised trial

“…We did not observe a significant effect of desflurane on blood concentrations of markers of myocardial ischaemia: troponin I and CK-MB. Earlier studies demonstrated conflicting results: a decreased concentration after volatile anaesthesia [12,14], or no effect [10,[15][16][17][18]. In two studies published recently, late postconditioning with sevoflurane used for sedation after coronary surgery also did not provide reduction of troponin release [19,20].…”

Inhalation versus intravenous anaesthesia for adults undergoing on-pump or off-pump coronary artery bypass grafting: A systematic review and meta-analysis of randomized controlled trials

“…• One trial in Japan [49], one in Korea [51]; three in India [73,76,77]; two in Taiwan [31,58]; and one trial in China [47]. • Three trials did not specify where the study was conducted [44,71,80].…”

“…Various anaesthetics agents were used in the different trials. 44 studies used propofol [ [30,42,60,62,63,70,78]; halothane in two trials [70,79]; sufentanil in three trials [37,43,62]; TIVA in six studies [26,34,40,56,73,76]; midazolam in six trials [36,37,44,52,62,70]; and, in one trial each, thiopental [60]; flunitrazepam [41]; and thiopentone and diazepam and fentanyl and droperidol and pancuronium [65].…”

“…9,[24][25][26][27][28][29][30][31][32][33]35,[37][38][39]41,42,44,45,[47][48][49][50][51][52][53][54][55][56][57]59,60,63, 64,67,69,71,72,74,75-78,80]; sevoflurane in 25 studies [9,24,28,29,32, 33-35,37,40,45,47,49,51,54-57,59,64,67,72,73,75,76]; desflurane in nine trials[25][26][27]33,34,43,68,71,76]; isoflurane 23 trials[31,35,36,38,39,41,44,48,50,52,53,…”