Cardiac Protection With Volatile Anesthetics in Stenting Procedures

• Published in: Journal of cardiothoracic and vascular anesthesia 2008-08, Vol.22 (4), p.543-547
• Main Authors: Landoni, Giovanni, MD, Zangrillo, Alberto, MD, Fochi, Oliviero, MD, Maj, Giulia, MD, Scandroglio, Anna Mara, MD, Morelli, Andrea, MD, Tritapepe, Luigi, MD, Montorfano, Matteo, MD, Colombo, Antonio, MD
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia & Perioperative Care; Anesthetics, Inhalation - administration & dosage; Cardiotonic Agents - administration & dosage; Coronary Artery Bypass - adverse effects; Coronary Artery Bypass - instrumentation; coronary stenting; Critical Care; Humans; inhalation anesthetics; Methyl Ethers - administration & dosage; Middle Aged; myocardial ischemia; Myocardial Ischemia - etiology; Myocardial Ischemia - prevention & control; myocardial preconditioning; Perioperative Care - adverse effects; Perioperative Care - instrumentation; Single-Blind Method; Stents; Volatilization
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2008.02.020

Objective: Myocardial ischemic damage is reduced by volatile anesthetics in patients undergoing coronary artery bypass graft surgery. The authors tested the hypothesis that low-dose sevoflurane could decrease perioperative myocardial damage, as measured by cTnI release, when compared with placebo, in patients undergoing interventional cardiology procedures. Design: A single-blind, randomized controlled trial. Setting: A university hospital. Participants: Thirty patients undergoing stenting procedures (May 2005) were included in the present study. Interventions: The authors randomly assigned 16 patients to breathe sevoflurane (expired end-tidal concentration 1%) and 14 patients to breathe a placebo oxygen/air mix before stenting procedures. Measurements and Main Results: Postprocedural cardiac troponin I release was measured as a marker of myocardial necrosis. Sixteen patients had detectable cardiac troponin I levels after stenting procedures, with no difference between groups: 10 in the sevoflurane group (16 patients) versus 6 in the placebo group (14 patients) ( p = 0.3). No difference in the amount of postprocedural median (interquartile range) cardiac troponin I release was noted between the sevoflurane group, 0.15 (0-4.73) ng/mL, and the placebo group, 0.14 (0-0.87) ng/mL ( p = 0.4). Conclusions: Myocardial damage measured by cardiac troponin release was not reduced by the volatile anesthetic sevoflurane during interventional cardiology procedures in this study.