Cardiac protection with volatile anesthetics in stenting procedures

J Cardiothorac Vasc Anesth. 2008 Aug;22(4):543-7. doi: 10.1053/j.jvca.2008.02.020. Epub 2008 May 14.

Abstract

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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Anesthetics, Inhalation / administration & dosage*
  • Cardiotonic Agents / administration & dosage*
  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Bypass / instrumentation*
  • Humans
  • Methyl Ethers / administration & dosage
  • Middle Aged
  • Myocardial Ischemia / etiology
  • Myocardial Ischemia / prevention & control
  • Perioperative Care / adverse effects
  • Perioperative Care / instrumentation
  • Sevoflurane
  • Single-Blind Method
  • Stents*
  • Volatilization

Substances

  • Anesthetics, Inhalation
  • Cardiotonic Agents
  • Methyl Ethers
  • Sevoflurane