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- Title
Cardiac outcome after sevoflurane versus propofol sedation following coronary bypass surgery: a pilot study.
- Authors
HELLSTRÖM, J.; ÖWALL, A.; BERGSTRÖM, J.; SACKEY, P. V.
- Abstract
Studies of volatile anesthetic administration during coronary artery bypass grafting (CABG) report reduced serum levels of post-operative cardiac troponin-T (cTnT). Our primary objective was to evaluate whether short-term sedation with sevoflurane in the intensive care unit (ICU) - after CABG - could affect the release of cTnT, compared with propofol sedation. Following isolated CABG with cardiopulmonary bypass, 100 patients were randomized to either sevoflurane via the Anesthetic Conserving Device (AnaConDa) or propofol for ICU sedation. Study drugs were administered for 2 h during mechanical ventilation and thereafter until extubation criteria were met. The primary endpoint was cTnT 12 h post-operatively. Crude cTnT data were not normally distributed and therefore compared with the Mann-Whitney U-test. Because of the skewed pre-operative and post-operative cTnT data, we performed a post hoc analysis of the change in cTnT between pre-operative values and 12 h post-operatively. There was no statistically significant difference between groups in the primary endpoint cTnT values at 12 h post-operatively, cardiac events or the need for hemodynamic support. In the post hoc analysis, the cTnT increase from pre-operative values to 12 h post-operatively was less pronounced in the sevoflurane group ( P=0.008). Post-operative short-term sevoflurane sedation following CABG, in comparison with propofol, did not affect the cTnT values at 12 h post-operatively and clinical outcome was equal between groups. The result from the post hoc analysis, with less cTnT change over time, is nevertheless hypothesis-generating and warrants a larger study.
- Subjects
DRUG administration; CORONARY artery bypass; ANESTHETICS; ANESTHESIA; CARDIOPULMONARY bypass
- Publication
Acta Anaesthesiologica Scandinavica, 2011, Vol 55, Issue 4, p460
- ISSN
0001-5172
- Publication type
Article
- DOI
10.1111/j.1399-6576.2011.02405.x