Table 14

Randomized Clinical Trials of Volatile Anesthetics in Patients Undergoing Coronary Artery Surgery

StudynAnestheticControlSurgical TechniqueEnd Point
Slogoff & Keats, 1989 (463)1012
  • Enflurane

  • Halothane

  • Isoflurane

High-dose sufentanilCPBNo difference in ischemia, MI, or death
Leung et al., 1991 (464)186IsofluraneHigh-dose sufentanilCPBNo difference in ischemia
Helman et al., 1992 (465)200DesfluraneHigh-dose sufentanilCPBIncreased ischemia during induction of anesthesia
Belhomme et al., 1999 (466)20Isoflurane before aortic cross-clampingNo volatile anestheticCPBNo difference in TnI activation of PKC
Penta de Peppo et al., 1999 (467)22Enflurane before CPBNo volatile anestheticCPBImproved LV function
Tomai et al., 1999 (468)40Isoflurane before CPBNo volatile anestheticCPBDecreased TnI in subset of patients with EF less than 50%
Haroun-Bizri et al., 2001 (469)49Isoflurane before CPBNo volatile anestheticCPBImproved LV function
De Hert et al., 2002 (470)20SevofluranePropofolCPBDecreased TnI; improved LV function
De Hert et al., 2003 (471)45
  • Sevoflurane

  • Desflurane

PropofolCPB; elderly; EF less than 50%Decreased TnI; improved LV function
Julier et al., 2003 (472); Garcia et al., 2005 (473)72Sevoflurane before aortic cross-clampingNo volatile anestheticCPBNo difference in TnI at 72 h; decreased BNP; decreased late cardiac events in the same study population
Conzen et al., 2003 (474)20SevofluranePropofolOPCABDecreased TnI
De Hert et al., 2004 (475)320Sevoflurane or desfluranePropofol or midazolamCPBDecreased TnI; decreased ICU and hospital LOS
Forlani et al., 2004 (476)60Isoflurane before CPBNo volatile anestheticCPBDecreased TnI and CK-MB
Bein et al., 2005 (477)52SevofluranePropofolMIDCABImproved LV function

BNP indicates brain natriuretic peptide; CK-MB, MB isoenzyme of creatine kinase; CPB, cardiopulmonary bypass; EF, ejection fraction; ICU, intensive care unit; LOS, length of stay; LV, left ventricle; MI, myocardial infarction; MIDCAB, minimally invasive direct coronary artery bypass; n, number of patients; OPCAB, off-pump coronary bypass; PKC, protein kinase C; and TnI, troponin I.