Related Experiment Video
Updated: Jun 24, 2026
04:56
In Vitro Method to Control Concentrations of Halogenated Gases in Cultured Alveolar Epithelial Cells
Published on: October 23, 2018
Volatile anesthetics reduce mortality in cardiac surgery
Elena Bignami1, Giuseppe Biondi-Zoccai, Giovanni Landoni
1Department of Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy.
Journal of Cardiothoracic and Vascular Anesthesia
|March 24, 2009
Summary
Volatile anesthetics may reduce mortality in cardiac surgery. This study found their use, particularly isoflurane, correlated with lower risk-adjusted death rates in coronary artery bypass graft patients.
Area of Science:
- Anesthesiology
- Cardiovascular Surgery
- Public Health
Background:
- The impact of volatile anesthetics on postoperative mortality after cardiac surgery remains debated.
- Previous meta-analyses suggested a potential benefit, but further investigation was warranted.
Purpose of the Study:
- To investigate the association between the use of volatile anesthetics and mortality in patients undergoing coronary artery bypass graft (CABG) surgery.
- To determine if specific volatile anesthetic agents or duration of use correlate with patient outcomes.
Main Methods:
- A longitudinal study involving 34,310 CABG interventions across 64 Italian centers.
- Risk-adjusted mortality ratios were estimated for each center.
- A survey assessed the correlation between volatile anesthetic use and mortality.
Main Results:
- Risk-adjusted analysis revealed that volatile anesthetic use was significantly associated with lower 30-day mortality (p = 0.035).
- Centers using volatile anesthetics in at least 25% of cases showed statistically significant lower mortality (p = 0.003).
- Longer use of volatile anesthetics (p = 0.022) and specifically isoflurane (p = 0.039) were linked to reduced risk-adjusted mortality rates.
Conclusions:
- The use of volatile agents in CABG surgery is associated with reduced risk-adjusted mortality.
- Findings support the use of volatile anesthetics to improve outcomes in cardiac surgical patients.
Related Concept Videos
01:24Parenteral Anesthetics: Overview
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
01:24General Anesthesia: Overview
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
01:20Inhalational Anesthetics: Overview
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
01:13Local Anesthetics: Pharmacokinetics
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
01:22Stages of General Anesthesia
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...