Xenon as an Adjuvant to Propofol Anesthesia in Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery: A Pragmatic Randomized Controlled Clinical Trial

Abstract

Thirty percent xenon added to propofol anesthesia improves hemodynamic stability by decreasing norepinephrine requirements in patients undergoing OPCAB surgery.

The effect of xenon‐augmented sevoflurane anesthesia on intraoperative hemodynamics and early postoperative neurocognitive function in children undergoing cardiac catheterization: A randomized controlled pilot trial

“…Interestingly, the adjuvant use of xenon still resulted in reduced requirements for ephedrine, which may facilitate intraoperative management of this vulnerable patient population. This finding confirms previous reports from other settings . While we are unable to completely rule out an interaction between the depth of anesthesia and the occurrence of hypotension, our data suggest that sevoflurane anesthesia is intrinsically associated with an increased risk of hypotension as compared to the combination of sevoflurane with xenon (and this independently from the anesthetic plane).…”

“…This finding confirms previous reports from other settings. 2,3,8 While we are unable to completely rule out an interaction between the depth of anesthesia and the occurrence of hypotension, our data suggest that sevoflurane anesthesia is intrinsically associated with an increased risk of hypotension as compared to the combination of sevoflurane with xenon (and this independently from the anesthetic plane). Interestingly, while sevoflurane patients required a total of nine ephedrine administrations to maintain predefined hemodynamic goals, only three of these administrations were necessary when the BIS was significantly lower than in the xenon group (at T10, T20, and T25, see Table S2).…”

“…The sample size was based on convenience because data on the hemodynamic and neurocognitive effects of xenon in children were not available in the literature when planning this trial. Based on various xenon trials of our group and other investigators in adults suffering from cardiac disease, a number of 40 children was expected to be sufficient to detect statistically significant differences in safety and efficacy parameters. A comparable sample size has also been used in several studies investigating postoperative cognitive functioning in children …”

“…In adults, the noble gas xenon has only minimal hemodynamic side effects when compared with other anesthetics . Moreover, in preclinical experiments, even subanesthetic doses of xenon have been demonstrated to possess cardio‐ and neuroprotective properties and to protect from anesthetic neurotoxicity .…”

“…In adults, the noble gas xenon has only minimal hemodynamic side effects when compared with other anesthetics. [1][2][3] Moreover, in preclinical experiments, even subanesthetic doses of xenon have been demonstrated to possess cardio-and neuroprotective properties 4,5 and to protect from anesthetic neurotoxicity. 6 Altogether, the favorable hemodynamic profile combined with its potential for organ-protection could render xenon an attractive option for anesthesia in children suffering from congenital heart disease (CHD).…”