What question did this study set out to answer?

To compare the intraoperative hemodynamic stability and adverse clinical outcomes of desflurane versus isoflurane in patients undergoing elective coronary artery bypass graft surgery.

November 1, 1991AnesthesiologyOpen Access

A Comparison of Desflurane and Isoflurane in Patients Undergoing Coronary Artery Surgery

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Why the study?

Does desflurane compared to isoflurane improve hemodynamic stability or clinical outcomes in patients undergoing elective coronary artery bypass surgery?

Population

Patients undergoing elective coronary artery bypass surgery with left ventricular ejection fraction >0.34.

Comparison

Desflurane as primary anesthetic to maintain… vs Isoflurane as primary anesthetic administered…

Design

Other

Follow-up

Perioperative

Authors

ITIan R. ThomsonCarleton University JBJohn BoweringSt. Paul's Hospital RHRobert J. HudsonUniversity of South Carolina

Discussion

Member takes

Implication

Comparable outcomes support either agent for elective CABG; larger trials needed before changing practice.

Key Points

To compare the intraoperative hemodynamic stability and adverse clinical outcomes of desflurane versus isoflurane in patients undergoing elective coronary artery bypass graft surgery.
Evaluated patients undergoing elective coronary artery bypass surgery with baseline left ventricular ejection fractions exceeding 0.34.
Administered either desflurane or isoflurane following standard anesthetic induction with thiopental (180 ± 45 mg) and fentanyl (10 µg/kg), titrating between 0 and 2.0 MAC to maintain target blood pressure and heart rate.
Both agents caused significant reductions in mean arterial pressure during skin preparation, falling from 97 ± 12 to 71 ± 5 mmHg with desflurane and from 95 ± 9 to 74 ± 9 mmHg with isoflurane.
One minute after sternotomy, mean arterial pressure returned to baseline in the isoflurane group (97 ± 9 mmHg) and was significantly higher than in the desflurane group (87 ± 12 mmHg), alongside higher systolic pressures after intubation, skin preparation, and sternotomy.
No significant differences occurred between groups regarding pre-cardiopulmonary bypass myocardial ischemic ECG changes, perioperative myocardial infarction, or perioperative mortality.

Structured PICO

Does desflurane compared to isoflurane improve hemodynamic stability or clinical outcomes in patients undergoing elective coronary artery bypass surgery?

Population

Patients undergoing elective coronary artery bypass surgery with left ventricular ejection fraction >0.34.

Intervention

Desflurane as primary anesthetic (after induction with thiopental and fentanyl) to maintain systolic blood pressure within 70-120% and heart rate <120% of preoperative values.

Comparator

Isoflurane as primary anesthetic administered under the same protocol.

Outcome

Hemodynamic effects (mean arterial pressure and systolic arterial pressure) at various perioperative time points.surrogate

Desflurane and isoflurane provide similar hemodynamic stability and clinical outcomes during elective coronary artery bypass surgery, though isoflurane maintains slightly higher arterial pressures at specific perioperative time points.

Cite This Study

Thomson et al. (1991) studied this question.

synapsesocial.com/papers/6a82bb6ffb68d755121c23cb https://doi.org/10.1097/00000542-199111000-00008

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A Comparison of Desflurane and Isoflurane in Patients Undergoing Coronary Artery Surgery

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

A Comparison of Desflurane and Isoflurane in Patients Undergoing Coronary Artery Surgery

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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