Title: | A comparison of volatile and non volatile agents for cardioprotection during on-pump coronary surgery |
Author(s): | De Hert, S.Vlasselaers, D.Barbe, R.Ory, J. P.Dekegel, D.Donnadonni, R.Demeere, J. L.Mulier, J.Wouters, P. |
Address: | Division of Cardiothoracic and Vascular Anaesthesiology, Academic Medical Center, Amsterdam, Netherlands. s.g.dehert@amc.uva.nl |
ISSN/ISBN: | 1365-2044 (Electronic). 0003-2409 (Linking) |
Abstract: | A randomised study of 414 patients undergoing coronary artery surgery with cardiopulmonary bypass was conducted to compare the effects of a volatile anaesthetic regimen with either deesflurane or sevoflurane, and a total intravenous anaesthesia (TIVA) regimen on postoperative troponin T release. The primary outcome variable was postoperative troponin T release, secondary outcome variables were hospital length of stay and 1-year mortality. Maximal postoperative troponin T values did not differ between groups (TIVA: 0.30 [0.00-4.79] ng x ml(-1) (median [range]), sevoflurane: 0.33 [0.02-3.68] ng x ml(-1), and desflurane: 0.39 [0.08-3.74] ng x ml(-1)). The independent predictors of hospital length of stay were the EuroSCORE (p < 0.001), female gender (p = 0.042) and the group assignment (p < 0.001). The one-year mortality was 12.3% in the TIVA group, 3.3% in the sevoflurane group, and 6.7% in the desflurane group. The EuroSCORE (p = 0.003) was the only significant independent predictor of 1-year mortality. |