title: Isoflurane does not increase the incidence of intraoperative myocardial ischaemia compared with halothane during vascular surgery.
abstract: We have studied the incidence of new intraoperative myocardial ischaemia (IMI), myocardial infarction (MI) and cardiac death (CD) in 500 consecutive patients undergoing elective major non-cardiac vascular surgery. Patients were allocated randomly to receive either halothane (n = 226) or isoflurane (n = 274) as principal anaesthetic agent. Using real-time ST segment trend analysis (leads V5 and II) IMI (halothane 39%, isoflurane 38%), MI (halothane 1.3%, isoflurane 1.5%) and CD (halothane 0.4%, isoflurane 0.7%) did not differ significantly between the two groups. Twenty-three per cent of IMI episodes were related to haemodynamic disturbances, but unrelated to the type of surgery: 148 supra-aortic (IMI = 39%), 244 abdominal aortic (IMI = 41%) and 108 lower extremity revascularizations (IMI = 33%). We conclude that the choice of volatile anaesthetic agent does not influence cardiac morbidity or mortality in this type of patient.
authors: Abteilung für Klinische Anaesthesiologie, Heinrich-Heine Universität Düsseldorf, F.R. Germany.
authors: K D
authors: KD
authors: Stühmeier
authors: B
authors: B
authors: Mainzer
authors: W
authors: W
authors: Sandmann
authors: J
authors: J
authors: Tarnow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000771:Anesthesia, Intravenous; D005260:Female; D006221:Halothane / Q000009:adverse effects*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007431:Intraoperative Complications / Q000139:chemically induced*; D007530:Isoflurane / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000139:chemically induced*; D011183:Postoperative Complications / Q000401:mortality; D011446:Prospective Studies; D014656:Vascular Surgical Procedures
chemical_list: D007530:Isoflurane; D006221:Halothane