Minerva cardioangiologica
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Minerva cardioangiologica · Aug 2008
ReviewVolatile anesthetics for periprocedural cardiac protection. A review.
All volatile anesthetics have cardiac depressant effects that decrease myocardial oxygen demand and may, therefore, have a beneficial role on the myocardial oxygen balance during ischemia. Recently, experimental evidence has clearly demonstrated that in addition to these indirect protective effects, volatile anesthetic agents also have direct protective properties against ischemic myocardial damage. ⋯ Multicenter, randomized clinical trials had previously demonstrated that the use of desflurane can reduce the postoperative release of cardiac troponin I, the need for inotropic support, and the number of patients requiring prolonged hospitalization, following coronary artery bypass graft surgery, either with and without cardiopulmonary bypass. Evidence in non-coronary surgical settings is contradictory and will be reviewed in this paper together with the mechanism of cardiac protection by volatile agents.