Effects of anesthetics on microvascular reactivity measured by vascular occlusion tests during off-pump coronary artery bypass surgery: a randomized controlled trial

Microvascular function may be modulated by various anesthetics. Desflurane and propofol anesthesia have different effects on microvascular function. However, there are few reports on the effects of sevoflurane and desflurane on microvascular function during cardiac surgery. We compared the effects o...

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Bibliographic Details
Published in:Journal of clinical monitoring and computing 2021-10, Vol.35 (5), p.1219-1228
Main Authors: Cho, Youn Joung, Yoo, Sol Ji, Nam, Karam, Bae, Jin Young, Lee, Seo Hee, Jeon, Yunseok
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesiology
Anesthetics
Blood gas analysis
Blood vessels
Coronary vessels
Critical Care Medicine
Gas analysis
Health Sciences
Intensive
Medicine
Medicine & Public Health
NCT
NCT03209193
Occlusion
Original Research
Oxygen content
Reactivity
Statistics for Life Sciences
Surgery
Vascular occlusion
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Summary:Microvascular function may be modulated by various anesthetics. Desflurane and propofol anesthesia have different effects on microvascular function. However, there are few reports on the effects of sevoflurane and desflurane on microvascular function during cardiac surgery. We compared the effects of sevoflurane and desflurane on microvascular reactivity, as measured by the vascular occlusion tests (VOTs) during off-pump coronary artery bypass (OPCAB) surgery. Patients undergoing OPCAB were eligible for study inclusion. Patients were excluded if they were unsuitable for treatment with volatile agents or the VOT, had renal failure or uncontrolled diabetes, or were pregnant. The enrolled patients were randomized to receive sevoflurane or desflurane during surgery. Tissue oxygen saturation (StO 2 ) dynamics during the VOT were measured at baseline (pre-anesthesia), pre-anastomosis, post-anastomosis of vessel grafts, and at the end of surgery. Macrohemodynamic variables, arterial blood gas parameters, and in-hospital adverse events were also evaluated. A total of 64 patients (32 in each group) were analyzed. StO 2 dynamics did not differ between the groups. Compared to baseline, StO 2 and the rate of recovery following vascular occlusion decreased at the end of surgery in both groups (adjusted p-value, 
ISSN:1387-1307
1573-2614
DOI:10.1007/s10877-020-00587-8