1. Effects of anesthetics on microvascular reactivity measured by vascular occlusion tests during off-pump coronary artery bypass surgery: a randomized controlled trial
- Author
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Sol Ji Yoo, Jin Young Bae, Seo Hee Lee, Yunseok Jeon, Karam Nam, and Youn Joung Cho
- Subjects
Methyl Ethers ,medicine.medical_specialty ,medicine.medical_treatment ,Coronary Artery Bypass, Off-Pump ,Health Informatics ,Critical Care and Intensive Care Medicine ,Vascular occlusion ,Sevoflurane ,Desflurane ,medicine ,Humans ,Adverse effect ,Propofol ,Off-pump coronary artery bypass ,Isoflurane ,business.industry ,Surgery ,Cardiac surgery ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Anesthetics, Inhalation ,Arterial blood ,medicine.symptom ,business ,medicine.drug ,Artery - Abstract
Microvascular function may be modulated by various anesthetics. Desflurane and propofol anesthesia have different effects on microvascular function. However, there are few reports on the effects of sevoflurane and desflurane on microvascular function during cardiac surgery. We compared the effects of sevoflurane and desflurane on microvascular reactivity, as measured by the vascular occlusion tests (VOTs) during off-pump coronary artery bypass (OPCAB) surgery. Patients undergoing OPCAB were eligible for study inclusion. Patients were excluded if they were unsuitable for treatment with volatile agents or the VOT, had renal failure or uncontrolled diabetes, or were pregnant. The enrolled patients were randomized to receive sevoflurane or desflurane during surgery. Tissue oxygen saturation (StO2) dynamics during the VOT were measured at baseline (pre-anesthesia), pre-anastomosis, post-anastomosis of vessel grafts, and at the end of surgery. Macrohemodynamic variables, arterial blood gas parameters, and in-hospital adverse events were also evaluated. A total of 64 patients (32 in each group) were analyzed. StO2 dynamics did not differ between the groups. Compared to baseline, StO2 and the rate of recovery following vascular occlusion decreased at the end of surgery in both groups (adjusted p-value
- Published
- 2020