Key result
Sevoflurane-based anesthesia reduces post-CABG oxidative stress marker carbonyls ~8% compared to TIVA.
Why the study?
The impact of anesthesia method on the severity of oxidative stress after coronary artery bypass grafting with cardiopulmonary bypass was investigated.
Does VIMA with sevoflurane reduce oxidative stress compared to TIVA with propofol and fentanyl in patients undergoing CABG with cardiopulmonary bypass?
RCT (n=131)
Computer-generated
Does VIMA with sevoflurane reduce oxidative stress compared to TIVA with propofol and fentanyl in patients undergoing CABG with cardiopulmonary bypass?
Absolute Event Rate: 0.81% vs 0.88%
p-value: p=0.01
Sevoflurane-based volatile induction and maintenance anesthesia reduces oxidative stress markers compared to total intravenous anesthesia in patients undergoing CABG with cardiopulmonary bypass.
Sevoflurane may lower oxidative stress markers versus propofol at 24h post-CABG; leaves open clinical relevance pending larger outcome trials.
The objective : to investigate the impact of anesthesia method on the severity of oxidative stress in patients after coronary artery bypass grafting with cardiopulmonary bypass. Subjects and methods . Patients were randomized (seed 6556 as of 04.01.2016, www.randomization.com) to Volatile Induction and Maintenance Anesthesia ( VIMA ) with Sevoflurane group ( n = 65) and Total Intravenous Anesthesia with Propofol and Fentanyl ( TIVA ) group ( n = 66). The changes in oxidative stress markers in blood plasma were studied: carbonylated proteins, nitrotyrosine, oxidized forms of lo w-d ensity lipoproteins – ox y- L DL . Results . At the critical stage with 24 hours after the surgery, statistically significant differences in the carbonyls blood levels were found between VIMA with Sevoflurane and TIVA with Propofol groups: 0.88 (0.79–0.96) nmo l/m g protein (nmo l/m g) in TIVA group vs 0.81 (0.75–0.91) nmo l/m g in VIMA group, p = 0.01; and ox y- L DL levels 0.96 ± 0.40 m g/m l vs 0.83 ± 0.33 m g/m l, respectively, p = 0.04. Nitrotyrosine demonstrated no diagnostic value. Conclusion. It has been suggested that sevoflurane possesses antioxidant properties that can be regarded as a positive quality of VIMA in coronary artery bypass grafting with cardiopulmonary bypass.
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GERASIMENKO et al. (2020) conducted an RCT in Coronary artery bypass grafting with cardiopulmonary bypass (n=131). Volatile Induction and Maintenance Anesthesia (VIMA) with Sevoflurane vs. Total Intravenous Anesthesia with Propofol and Fentanyl (TIVA) was evaluated on Carbonyls blood levels at 24 hours after surgery (p=0.01). Volatile Induction and Maintenance Anesthesia with Sevoflurane significantly reduced carbonyl blood levels compared to Total Intravenous Anesthesia at 24 hours post-CABG (0.81 vs 0.88 nmol/mg; p=0.01).
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