Issn Print: 0265-0215

Publication Date: 2007/06/01


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Effects of volatile anaesthesia versus total intravenous anaesthesia on inotrope use and time of stay in Intensive Care Unit on CABG patients: O-37

R. Drwila; M. Zietkiewicz; D. Plicner; B. Kapelak; J. Sadowski; J. Andres

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Author Information: Department of Anesthesiology, 2Department of Cardiovascular Surgery, CM Jagiellonian University, Krakow, Poland

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Introduction: Many studies have analysed the role of volatile anaesthetic agents in myocardial protection during coronary artery bypass graft (CABG) surgery and some have identified beneficial effects [1]. The purpose of the current study was to evaluate the effects of volatile anaesthesia versus total intravenous anaesthesia on dose and frequency of inotropes use and time of stay in Intensive Care Unit in on-pump CABG patients.
Method: From January 2000 to September 2004 367 consecutive patients underwent primary elective CABG performed exclusively by two selected cardiac surgeons with similar surgical experience. Of this group 159 patients received sevoflurane before cardiopulmonary bypass (CPB) (Treatment Group) and 208 patients received total intravenous anaesthesia (Control Group). Subsequently, with the use of cluster analysis, the whole studied population was divided into group A (175 patients) and group B (153 patients) based on the levels of creatine kinase activity determined at 12 h and 24 h postoperatively. Creatine kinase activity at 12 h was lower in group A than in group B (409.14 ± 139.59 vs. 972.15 ± 629.41 U/I). Also creatine kinase myocardial fraction activity at 12h was lower in group A (15.03 ± 6.25 vs. 58.14 ± 62.57 U/I). Analysis of variance (ANOVA), followed by Kruskal-Wallis, chi squared, and Fisher's tests were used for statistical analysis. Data in A and B group of patients were determined separately.
Results: Lower number of patients in group A who received sevoflurane anaesthesia required postoperative inotropic support compared to total intravenous anesthesia patients (28% versus 72%, P = 0.0429). The effect of volatile and total intravenous anaesthesia on daily dose of inotropes and time of stay in Intensive Care Unit was not observed either in A or B group of patients.
Discussion: In CABG patients with lower postoperative CK/CK-MB activity (group A) volatile anaesthesia decreased the need for inotropic support. It might suggest a protective influence of sevoflurane on myocardium.
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