Anaesthetic Drugs and Survival in Cardiac Surgery
Anaesthetic Drugs and Survival in Cardiac Surgery
Volatile anaesthetics improve survival in cardiac surgery when compared with TIVA. No clear data exist to suggest that one volatile agent (isoflurane, desflurane, or sevoflurane) is more beneficial than others, but there is preliminary evidence to suggest that TIVA is detrimental when compared with desflurane and sevoflurane. Cardiac anaesthesiologists, cardiac surgeons, and perfusionists should be aware that anaesthetics have pharmacological properties that go beyond the pharmacodynamic or pharmacokinetic properties and that the anaesthetic plan should take into account the effect of these drugs on survival. As the evidence comes from small trials, it is imperative to conduct a large, multicentre trial to confirm that 1 yr survival is significantly influenced by the choice of the anaesthetic.
Conclusions
Volatile anaesthetics improve survival in cardiac surgery when compared with TIVA. No clear data exist to suggest that one volatile agent (isoflurane, desflurane, or sevoflurane) is more beneficial than others, but there is preliminary evidence to suggest that TIVA is detrimental when compared with desflurane and sevoflurane. Cardiac anaesthesiologists, cardiac surgeons, and perfusionists should be aware that anaesthetics have pharmacological properties that go beyond the pharmacodynamic or pharmacokinetic properties and that the anaesthetic plan should take into account the effect of these drugs on survival. As the evidence comes from small trials, it is imperative to conduct a large, multicentre trial to confirm that 1 yr survival is significantly influenced by the choice of the anaesthetic.
