The effects of interrupted or continuous administration of sevoflurane on preconditioning before cardio‐pulmonary bypass in coronary artery surgery: comparison with continuous propofol

Summary Volatile anaesthetics have been shown to exert cardioprotective properties in experimental and clinical studies. However, the mode of administration may influence these cardioprotective effects. The present study was designed to compare the effect of interrupted administration of sevoflurane...

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Bibliographic Details
Published in:Anaesthesia 2008-10, Vol.63 (10), p.1046-1055
Main Authors: Bein, B., Renner, J., Caliebe, D., Hanss, R., Bauer, M., Fraund, S., Scholz, J.
Format: Article
Language:English
Subjects:
Aged
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthesiology
Anesthetics, Inhalation - administration & dosage
Anesthetics, Intravenous - administration & dosage
Biological and medical sciences
Biomarkers - blood
Cardiopulmonary Bypass
Cardiotonic Agents - administration & dosage
Cardiovascular system
Creatine Kinase, MB Form - blood
Drug Administration Schedule
Echocardiography, Transesophageal
Female
Heart surgery
Hemodynamics - drug effects
Humans
Ischemic Preconditioning, Myocardial - methods
Male
Medical sciences
Methyl Ethers - administration & dosage
Middle Aged
Pharmacology
Propofol - administration & dosage
Troponin T - blood
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Summary:Summary Volatile anaesthetics have been shown to exert cardioprotective properties in experimental and clinical studies. However, the mode of administration may influence these cardioprotective effects. The present study was designed to compare the effect of interrupted administration of sevoflurane before cardiopulmonary bypass with continuous sevoflurane administration and with propofol‐only anaesthesia, on cardioprotection as assessed by left ventricular performance and myocardial cell damage during coronary artery bypass grafting. Forty‐two patients scheduled for coronary bypass surgery were randomly assigned to one of three groups: propofol‐only (P; n = 14), continuous (SevoC; n = 14) and interrupted sevoflurane administration (SevoI; n = 14). Myocardial cell damage as assessed by Troponin T (cTNT) and creatine kinase MB (CK‐MB) were chosen as the primary endpoints and echocardiographic myocardial performance index (MPI) measurements were also performed. Up to 48 h postoperatively, in group SevoI, postoperative cTNT values (mean (SD) 0.13 (0.04) ng.ml−1) were significantly (p 
ISSN:0003-2409
1365-2044
DOI:10.1111/j.1365-2044.2008.05563.x