Key result
Inhalational anesthesia with sevoflurane or desflurane resulted in comparable changes in cardiac troponin-T levels compared to TIVA with propofol after off-pump coronary artery bypass surgery.
Why the study?
Does inhalational anesthesia with sevoflurane or desflurane improve myocardial protection compared to total intravenous anesthesia with propofol in patients undergoing elective OPCAB surgery?
RCT (n=139)
randomly allocated
Does inhalational anesthesia with sevoflurane or desflurane improve myocardial protection compared to total intravenous anesthesia with propofol in patients undergoing elective OPCAB surgery?
Inhalational anesthesia with sevoflurane or desflurane does not provide superior myocardial protection compared to total intravenous anesthesia with propofol during elective off-pump coronary artery bypass surgery.
Comparable troponin release shows no myocardial protection advantage for volatiles over propofol TIVA in OPCAB; challenges cardioprotective assumptions and supports choice by non-cardiac factors.
AIMS AND OBJECTIVES: The objective of the study was to evaluate the myocardial protective effect of volatile agents-sevoflurane and desflurane versus total intravenous anesthesia (TIVA) with propofol in offpump coronary artery bypass surgery (OPCAB) by measuring cardiac troponin-T (cTnT) as a marker of myocardial cell death. MATERIALS AND METHODS: The study was conducted on 139 patients scheduled to undergo elective OPCAB surgery. The patients were randomly allocated to receive anesthesia with sevoflurane, desflurane or TIVA with propofol. The cTnT levels were measured preoperatively, at arrival in postoperative intensive care unit, at 8, 24, 48 and 96 hours thereafter. RESULTS: The changes in cTnT levels at all time intervals were comparable in the three groups. CONCLUSION: The study did not reveal any difference in myocardial protection after OPCAB with either sevoflurane or desflurane or TIVA using propofol as assessed by measuring serial cTnT values.
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Suryaprakash et al. (2013) conducted an RCT in elective off-pump coronary artery bypass surgery (n=139). Inhalational anesthesia with sevoflurane or desflurane vs. Total intravenous anesthesia (TIVA) with propofol was evaluated on Cardiac troponin-T (cTnT) levels. Inhalational anesthesia with sevoflurane or desflurane resulted in comparable changes in cardiac troponin-T levels compared to TIVA with propofol after off-pump coronary artery bypass surgery.
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