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November 1, 1992Anesthesia & Analgesia

Effects of Surgical Stress and Volatile Anesthetics on Left Ventricular Global and Regional Function in Patients With Coronary Artery Disease Evaluation by Computer-Assisted Two-Dimensional Quantitative Transesophageal Echocardiography

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Key result

Isoflurane was more likely to cause regional wall motion changes than halothane or enflurane when used to control intraoperative hypertension in patients with coronary artery disease.

Why the study?

Do different volatile anesthetics (halothane, enflurane, isoflurane) differentially affect left ventricular global and regional function in patients with coronary artery disease?

Population

39 patients with coronary artery disease experiencing intraoperative hypertension during surgery (sternotomy)

Comparison

Inhaled anesthetics administered to control… vs Comparison among the three volatile anesthetics…

Design

Cohort

Follow-up

Intraoperative

Authors

EHErik HoultzSahlgrenska University HospitalTGTomas GustavssonKarlstad UniversityKCKenneth CaidahlCardiac Imaging

Discussion

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Implication

May warrant caution with isoflurane in CAD patients; leaves open whether RCTs would confirm differential wall motion effects.

Structured PICO

Do different volatile anesthetics (halothane, enflurane, isoflurane) differentially affect left ventricular global and regional function in patients with coronary artery disease?

P
Population
39 patients with coronary artery disease undergoing surgery where volatile anesthetics were used to control intraoperative hypertension.
I
Intervention
Inhaled anesthetics (halothane, enflurane, or isoflurane) administered to control intraoperative hypertension
C
Comparator
Comparison among the three volatile anesthetics (halothane, enflurane, isoflurane) and baseline/sternotomy measurements
O
Outcome
Central hemodynamics and left ventricular global and regional function (global area ejection fraction [GAEF] and segmental area ejection fraction [SAEF]) measured by transesophageal echocardiographysurrogate

Main Result

p-value: p=<0.05

In patients with coronary artery disease, isoflurane is more likely to induce regional wall motion abnormalities during surgical stress compared to halothane or enflurane.

Cite This Study

Houltz et al. (1992) studied Coronary artery disease (n=39). Isoflurane vs. Halothane and enflurane was evaluated on Central hemodynamics and left ventricular global and regional function (p=<0.05). Isoflurane was more likely to cause regional wall motion changes than halothane or enflurane when used to control intraoperative hypertension in patients with coronary artery disease.

synapsesocial.com/papers/6a9305f28fa104a887e9c8a5https://doi.org/10.1213/00000539-199211000-00005

Topics

Echocardiography
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effects of halothane and isoflurane on left ventricular diastolic function during surgical stress in patients with coronary artery disease1997 · 22 citations
  2. 2Echocardiographic Assessment of Ventricular Performance Following Induction with Two Anesthetics1978 · 22 citations
  3. 3Global and Regional Myocardial Blood Flow and Metabolism during Equipotent Halothane and Isoflurane Anesthesia in Patients with Coronary Artery Disease1988 · 53 citations
  4. 4Control of Intraoperative Hypertension with Isoflurane in Patients with Coronary Artery Disease1989 · 16 citations
  5. 5Myocardial Function during Halothane and Enflurane Anesthesia in Patients with Coronary Artery Disease1980 · 32 citations