Exploration of xenon as a potential cardiostable sedative: a comparison with propofol after cardiac surgery.
Xenon anaesthesia is thought to have minimal haemodynamic side-effects. It is, however, expensive and requires special delivery systems for economic use. In this randomised cross-over study, we: (i) investigated the haemodynamic profile and recovery characteristics of xenon compared with propofol sedation in postoperative cardiac surgery patients, and (ii) evaluated a fully closed breathing system to minimise xenon consumption. We demonstrated a significantly faster recovery from xenon (3 min 11 s) than propofol sedation (25 min 23 s). Relative to propofol, xenon sedation produced no change in heart rate or mean arterial pressure and there were significantly higher mean values for central venous pressure (10.6 vs. 8.9 mmHg), pulmonary artery occlusion pressure (11.2 vs. 9.5 mmHg), mean pulmonary artery pressure (20.1 vs. 18.3 mmHg) and systemic vascular resistance index (2170 vs. 1896 dyn.s.cm-5.m-2). The haemodynamic profile seen with propofol reflected its known vasodilator effects. This was supported by the almost identical left ventricular stroke work indexes seen with both methods of sedation.
Dingley
J
J
Cardiac Centre, Morriston Hospital, Swansea SA6 6NL, UK. john.dingley@morrnhst-tr.wales.nhs.uk
King
R
R
Hughes
L
L
Terblanche
C
C
Mahon
S
S
Hepp
M
M
Youhana
A
A
Watkins
A
A
D000368:Aged; D000764:Anesthesia, Closed-Circuit / Q000379:methods; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000494:pharmacology; D016292:Procedural Sedation / Q000379:methods*; D001026:Coronary Artery Bypass; D018592:Cross-Over Studies; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D015742:Propofol / Q000494:pharmacology; D014978:Xenon / Q000494:pharmacology*
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D014978:Xenon; D015742:Propofol