Myocardial protection by isoflurane vs. sevoflurane in ultra-fast-track anaesthesia for off-pump aortocoronary bypass grafting

Hemmerling, Thomas M.; Olivier, J; Lê, Nhiên; Prieto, Ignatio; Bracco, David

doi:10.1017/s0265021507002608

Cited by 43 publications

(27 citation statements)

References 28 publications

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“…22 Sevoflurane was found to be cardioprotective in patients undergoing cardiac surgery. [10][11][12][13] In the current study, we did not find a difference in the degree of myocardial injury between the sevoflurane and the control groups. Patients in both groups received pPCI relatively quickly, along with contemporary medical therapy that included, in most patients, administration of IIbIIIa inhibitors and frequent use of aspiration thrombectomy.…”

Section: Discussioncontrasting

confidence: 61%

“…Sevoflurane administration during cardiac surgery was found to reduce the incidence of MI, intensive care unit and hospital stay, time on mechanical ventilation, in-hospital mortality, and long-term cardiac events. [10][11][12][13] A recent meta-analysis demonstrated that volatile agents and, in particular, sevoflurane and desflurane reduce mortality after cardiac surgery compared with intravenous anesthesia. 14 There are few data regarding the effect of sevoflurane during PCI.…”

mentioning

confidence: 99%

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Sevoflurane in acute myocardial infarction: A pilot randomized study

Lavi

Bainbridge

D'Alfonso

et al. 2014

American Heart Journal

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Section: Discussioncontrasting

confidence: 61%

mentioning

confidence: 99%

Sevoflurane in acute myocardial infarction: A pilot randomized study

Lavi

Bainbridge

D'Alfonso

et al. 2014

American Heart Journal

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“…We avoided the use of desflurane because of tachycardia [11]. Isoflurane and sevoflurane have been shown to be quite similar in outcome [12]. The direct cardiac effects of Thiopentone and Propofol do not show significant differences when compared in vivo [13].…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Management for Cesarean Delivery in a Patient with Severe Aortic Stenosis and Severe Obesity

Ghosh

Márton

2009

OBES SURG

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Valvular heart disease has significant effect on the maternal and fetal outcome of pregnancy. The severity and extent of aortic stenosis is of great value for risk assessment and for the design of a therapeutic plan. The therapeutic plan for such patients is further complicated by severe obesity. We report a case describing the anesthetic management of an extremely obese patient for cesarean delivery with severe aortic valve stenosis and regurgitation. The case was made complex due to the patient's deteriorating condition and not offering consent to emergency surgical procedures. The 34-year-old parturient underwent cesarean delivery at 32 weeks gestation under general anesthesia in the presence of a cardiothoracic surgical team. This case report demonstrates the importance of multidisciplinary preoperative assessment in such patients and careful anesthetic planning to avoid the deterioration of perioperative cardiac performance in parturients with complex valvular disease.

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“…9 When compared with intravenous anesthesia, sevoflurane has been shown to reduce the incidence of MI and intensive care unit stay, the length of time on mechanical ventilation following cardiac surgery, in-hospital mortality, and long-term cardiac events. [10][11][12][13][14] The effect of sevoflurane as a cardioprotective agent has not been shown in all studies, 15 and results were also dependent on duration of administration, number of exposures, and dose. For instance, in one study, the beneficial effects were observed only when administered throughout the surgery and not when administered in a fashion similar to ischemic conditioning, before cardiopulmonary bypass, or following the creation of the coronary anastomosis.…”

Section: Résumémentioning

confidence: 91%

One-year outcome of the sevoflurane in acute myocardial infarction randomized trial

Lavi

Alemayehu

McCarty

et al. 2015

Can J Anesth/J Can Anesth

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Background Sevoflurane is an inhalation anesthetic that has cardioprotective effects. There is limited information regarding its use outside of the operating room and its potential protective effect for patients presenting with myocardial infarction. Methods In the Sevoflurane In Acute Myocardial Infarction trial, patients with a first acute ST-elevation myocardial infarction (STEMI) who were treated by primary percutaneous coronary intervention were randomized to inhalation of sevoflurane or oxygen (control). From the time of the patient's arrival for cardiac catheterization, the anesthesia team administered sevoflurane or oxygen for 30 min using a tight-fitting mask.In this substudy, we report the one-year outcomes. Patients were followed clinically for one year; they underwent a thallium cardiac viability study at six months and an echocardiogram at one year. Results Forty-six patients completed follow-up. One patient in the sevoflurane group died. The mean [standard deviation (SD)] ejection fraction by singlephoton emission computed tomography at six months was 51.7 (7.7)% in the sevoflurane group and 51 (9.1)% in the control group (mean difference, 0.7%; 95% confidence interval [CI], -5.9 to 7.3; P = 0.831). The median [interquartile range] amount of scarring at six months was 0% [0 -8] in the sevoflurane group and 2.5% [0 -7.1] in control group (mean difference, -0.1%; 95% CI, -4.6 to 4.4; P = 0.700). The mean (SD) percentage of hibernating myocardium was similar in both groups 0% [0, 5] (mean difference, -1.3%; 95% CI, -3.4 to 0.9; P = 0.259). The mean (SD) ejection fraction at one year increased compared with baseline by 8.0 (9.1)% (P \ 0.001).Conclusions In this study, we did not find an effect of sevoflurane on left ventricular function or myocardial injury at one year post STEMI. This trial was registered at www.clinicaltrials.gov; identifier: NCT00971607. RésuméContexte Le sévoflurane est un anesthésique inhalé qui a des effets cardioprotecteurs. On ne dispose que de peu Meeting presentation: Presented in part at the Canadian Cardiovascular Congress in Vancouver, 2014 and published as an abstract (Can J Cardiol 2014, 30 (10): s62.).

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Myocardial protection by isoflurane vs. sevoflurane in ultra-fast-track anaesthesia for off-pump aortocoronary bypass grafting

Cited by 43 publications

References 28 publications

Sevoflurane in acute myocardial infarction: A pilot randomized study

Sevoflurane in acute myocardial infarction: A pilot randomized study

Anesthetic Management for Cesarean Delivery in a Patient with Severe Aortic Stenosis and Severe Obesity

One-year outcome of the sevoflurane in acute myocardial infarction randomized trial

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