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Volatile Agents for Cardiac Protection in Noncardiac Surgery: A Randomized Controlled Study
- Source :
- Journal of Cardiothoracic and Vascular Anesthesia. 25:902-907
- Publication Year :
- 2011
- Publisher :
- Elsevier BV, 2011.
-
Abstract
- "OBJECTIVE: Volatile anesthetics reduce the risk of myocardial infarction and mortality in coronary artery surgery. Recently, the American College of Cardiology\/American Heart Association Guidelines suggested the use of volatile anesthetic agents for the maintenance of general anesthesia during noncardiac surgery in patients at risk for perioperative myocardial ischemia, but no randomized experience to document the cardioprotective effects of these agents exists in this setting. Therefore, the authors performed a prospective, randomized, controlled trial to compare the effects of sevoflurane versus total intravenous anesthesia, in terms of postoperative cardiac troponin I release in patients undergoing noncardiac surgery.. . DESIGN: A randomized, controlled trial.. . SETTING: A teaching hospital.. . PARTICIPANTS: Eighty-eight consecutive patients undergoing noncardiac surgery.. . INTERVENTIONS: Patients were allocated randomly to receive either volatile anesthetic (44 patients) as the main anesthetic agent or total intravenous anesthesia (TIVA) (44 patients).. . MEASUREMENTS: Postoperative cardiac troponin I release was measured as a marker of myocardial necrosis. Patients with detectable postoperative troponin I in the sevoflurane group (12\/44, 27.3%) were similar to those in the propofol group (9\/44, 20.5%; p = 0.6). There was no significant reduction of postoperative median peak cTnI release (0.16 ± 0.71 ng\/mL in the sevoflurane group compared with the TIVA group, 0.03 ± 0.08 ng\/mL; p = 0.4). Three patients died at the 1-year follow-up for noncardiac causes (2 in the TIVA group).. . CONCLUSIONS: In the authors' experience, patients undergoing noncardiac surgery did not benefit from anesthesia based on halogenated anesthetics. Further studies are necessary to evaluate the cardioprotective effects of volatile agents in noncardiac surgery.. . "
- Subjects :
- Male
Methyl Ethers
medicine.medical_specialty
Cardiotonic Agents
Sevoflurane
law.invention
Necrosis
Randomized controlled trial
law
Troponin I
medicine
Humans
Prospective Studies
Myocardial infarction
Propofol
Aged
business.industry
Perioperative
Middle Aged
Vascular surgery
medicine.disease
Surgery
Anesthesiology and Pain Medicine
Cardiothoracic surgery
Surgical Procedures, Operative
Anesthesia
Anesthetics, Inhalation
Anesthesia, Intravenous
Female
Anesthesia, Inhalation
Cardiology and Cardiovascular Medicine
business
Anesthetics, Intravenous
medicine.drug
Subjects
Details
- ISSN :
- 10530770
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiothoracic and Vascular Anesthesia
- Accession number :
- edsair.doi.dedup.....0093693962736dc0a3c17e4274f3ceb5
- Full Text :
- https://doi.org/10.1053/j.jvca.2011.06.016