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Non-Intubated Video-Assisted Thoracoscopic Surgery
Published on: May 26, 2023
Volatile agents for cardiac protection in noncardiac surgery: a randomized controlled study
Alberto Zangrillo1, Valentina Testa, Valeria Aldrovandi
1Department of Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy.
Journal of Cardiothoracic and Vascular Anesthesia
|August 30, 2011
Summary
This study found that volatile anesthetics like sevoflurane did not reduce cardiac troponin I release in noncardiac surgery patients. Further research is needed to confirm the cardioprotective effects of volatile agents in this setting.
Area of Science:
- Anesthesiology
- Cardiology
- Perioperative Medicine
Background:
- Volatile anesthetics are suggested for perioperative myocardial ischemia risk reduction in noncardiac surgery.
- Evidence from randomized trials on their cardioprotective effects in this setting is limited.
Purpose of the Study:
- To compare the effects of sevoflurane versus total intravenous anesthesia (TIVA) on postoperative cardiac troponin I release.
- To evaluate the cardioprotective potential of volatile anesthetics in noncardiac surgery.
Main Methods:
- Prospective, randomized, controlled trial.
- 88 patients undergoing noncardiac surgery were randomized to sevoflurane or TIVA.
- Postoperative cardiac troponin I release was measured as a marker of myocardial necrosis.
Main Results:
- No significant difference in detectable postoperative troponin I between sevoflurane and TIVA groups (27.3% vs 20.5%).
- No significant reduction in median peak cTnI release with sevoflurane compared to TIVA.
- Similar 1-year mortality rates between groups.
Conclusions:
- Anesthesia based on halogenated anesthetics did not demonstrate benefit in reducing myocardial injury in this cohort.
- Further studies are required to definitively assess the cardioprotective effects of volatile agents in noncardiac surgery.
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