The Influence of Propofol Versus Sevoflurane Anesthesia on Outcome in 10,535 Cardiac Surgical Procedures

Jakobsen, Carl-Johan; Berg, H.; Hindsholm, K. B.; Faddy, Nicolas; Sloth, Erik

doi:10.1053/j.jvca.2007.03.002

Cited by 127 publications

(87 citation statements)

References 25 publications

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“…9 When compared with intravenous anesthesia, sevoflurane has been shown to reduce the incidence of MI and intensive care unit stay, the length of time on mechanical ventilation following cardiac surgery, in-hospital mortality, and long-term cardiac events. [10][11][12][13][14] The effect of sevoflurane as a cardioprotective agent has not been shown in all studies, 15 and results were also dependent on duration of administration, number of exposures, and dose. For instance, in one study, the beneficial effects were observed only when administered throughout the surgery and not when administered in a fashion similar to ischemic conditioning, before cardiopulmonary bypass, or following the creation of the coronary anastomosis.…”

Section: Résumémentioning

confidence: 92%

One-year outcome of the sevoflurane in acute myocardial infarction randomized trial

Lavi

Alemayehu

McCarty

et al. 2015

Can J Anesth/J Can Anesth

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Background Sevoflurane is an inhalation anesthetic that has cardioprotective effects. There is limited information regarding its use outside of the operating room and its potential protective effect for patients presenting with myocardial infarction. Methods In the Sevoflurane In Acute Myocardial Infarction trial, patients with a first acute ST-elevation myocardial infarction (STEMI) who were treated by primary percutaneous coronary intervention were randomized to inhalation of sevoflurane or oxygen (control). From the time of the patient's arrival for cardiac catheterization, the anesthesia team administered sevoflurane or oxygen for 30 min using a tight-fitting mask.In this substudy, we report the one-year outcomes. Patients were followed clinically for one year; they underwent a thallium cardiac viability study at six months and an echocardiogram at one year. Results Forty-six patients completed follow-up. One patient in the sevoflurane group died. The mean [standard deviation (SD)] ejection fraction by singlephoton emission computed tomography at six months was 51.7 (7.7)% in the sevoflurane group and 51 (9.1)% in the control group (mean difference, 0.7%; 95% confidence interval [CI], -5.9 to 7.3; P = 0.831). The median [interquartile range] amount of scarring at six months was 0% [0 -8] in the sevoflurane group and 2.5% [0 -7.1] in control group (mean difference, -0.1%; 95% CI, -4.6 to 4.4; P = 0.700). The mean (SD) percentage of hibernating myocardium was similar in both groups 0% [0, 5] (mean difference, -1.3%; 95% CI, -3.4 to 0.9; P = 0.259). The mean (SD) ejection fraction at one year increased compared with baseline by 8.0 (9.1)% (P \ 0.001).Conclusions In this study, we did not find an effect of sevoflurane on left ventricular function or myocardial injury at one year post STEMI. This trial was registered at www.clinicaltrials.gov; identifier: NCT00971607. RésuméContexte Le sévoflurane est un anesthésique inhalé qui a des effets cardioprotecteurs. On ne dispose que de peu Meeting presentation: Presented in part at the Canadian Cardiovascular Congress in Vancouver, 2014 and published as an abstract (Can J Cardiol 2014, 30 (10): s62.).

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Section: Résumémentioning

confidence: 92%

One-year outcome of the sevoflurane in acute myocardial infarction randomized trial

Lavi

Alemayehu

McCarty

et al. 2015

Can J Anesth/J Can Anesth

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“…4,12 Other analyses compared sevoflurane with propofol directly and showed potential beneficial effects of both treatments, depending on the outcome or subpopulation of patients assessed. 13,14 In one analysis, the authors concluded that ''sevoflurane and propofol both possess some, although different, cardioprotective properties.'' 13 Perhaps this statement summarizes the potential equipoise between treatments and/or inherent limitations of this approach.…”

mentioning

confidence: 99%

“…13,14 In one analysis, the authors concluded that ''sevoflurane and propofol both possess some, although different, cardioprotective properties.'' 13 Perhaps this statement summarizes the potential equipoise between treatments and/or inherent limitations of this approach.…”

mentioning

confidence: 99%

“…4,12 D'autres analyses ont directement comparé le sévoflurane au propofol et ont montré des effets bénéfiques potentiels pour les deux traitements, selon le critère d'évaluation retenu ou la sous-population de patients évaluée. 13,14 Dans une analyse, les auteurs ont conclu que « le sévoflurane et le propofol possèdent tous deux certaines propriétés cardioprotectrices, bien qu'elles soient différentes ». 13 Peut-être que cette phrase résume bien l'incertitude absolue potentielle entre divers traitements et/ou les limites inhérentes à une telle approche.…”

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“…13,14 Dans une analyse, les auteurs ont conclu que « le sévoflurane et le propofol possèdent tous deux certaines propriétés cardioprotectrices, bien qu'elles soient différentes ». 13 Peut-être que cette phrase résume bien l'incertitude absolue potentielle entre divers traitements et/ou les limites inhérentes à une telle approche.…”

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L’étude de la cardioprotection induite par le propofol: du mécanisme au phénomène clinique, et vice-versa

Hare

2015

Can J Anesth/J Can Anesth

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NF‐kB signaling in cardiomyocytes is inhibited by sevoflurane and promoted by propofol

et al. 2020

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Both inhalational and intravenous anesthetics affect myocardial remodeling, but the precise effect of each anesthetic on molecular signaling in myocardial remodeling is unknown. Here, we performed in silico analysis to investigate signaling alterations in cardiomyocytes induced by inhalational [sevoflurane (Sevo)] and intravenous [propofol (Prop)] anesthetics. Bioinformatics analysis revealed that nuclear factor‐kappa B (NF‐kB) signaling was inhibited by Sevo and promoted by Prop. Moreover, nuclear accumulation of p65 and transcription of NF‐kB‐regulated genes were suppressed in Sevo‐administered mice, suggesting that Sevo inhibits the NF‐kB signaling pathway. Our data demonstrate that NF‐kB signaling is inhibited by Sevo and promoted by Prop. As NF‐kB signaling plays an important role in myocardial remodeling, our results suggest that anesthetics may affect myocardial remodeling through NF‐kB.

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The Influence of Propofol Versus Sevoflurane Anesthesia on Outcome in 10,535 Cardiac Surgical Procedures

Cited by 127 publications

References 25 publications

One-year outcome of the sevoflurane in acute myocardial infarction randomized trial

One-year outcome of the sevoflurane in acute myocardial infarction randomized trial

L’étude de la cardioprotection induite par le propofol: du mécanisme au phénomène clinique, et vice-versa

NF‐kB signaling in cardiomyocytes is inhibited by sevoflurane and promoted by propofol

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