How “Volatile” Is the Protection Provided by Inhalational Anesthetics?

Volatile anaesthetics added to cardiopulmonary bypass are associated with reduced cardiac troponin

“…Published randomised control trials in cardiac surgery found that assignment to volatile anaesthesia gives a better outcome than propofol, but we still do not know why. 31 One of the major strengths of this study is that it corresponds to daily clinical practice, since we did not add any inclusion or exclusion criteria and we analysed all surgical interventions performed during the study period. This could also represent a limitation of the study and it is probably the reason why we did not find differences in clinically relevant outcomes, such as mechanical ventilation time and ICU or hospital stay.…”

“…Published randomised control trials in cardiac surgery found that assignment to volatile anaesthesia gives a better outcome than propofol, but we still do not know why. 31…”

Anesthetic Preconditioning: Have We Found the Holy Grail of Perioperative Cardioprotection?

“…Even more, in the noncardiac surgical setting, to date, no study was able to demonstrate any protective effect of volatile anesthetics in terms of postoperative cardiac adverse events. [15][16][17][18][19][20] Now, in 2018, it seems that the great expectations we once had with regard to potential clinical implications of myocardial anesthetic preconditioning have not been met. Multiple reasons have been invoked to explain the discrepancy between obvious effects in the animal experimental set-up and the absence of substantial impact in daily clinical reality.…”