Cardiac protection with volatile anesthetics in stenting procedures.
OBJECTIVE
Myocardial ischemic damage is reduced by volatile anesthetics in patients undergoing coronary artery bypass graft surgery. The authors tested the hypothesis that low-dose sevoflurane could decrease perioperative myocardial damage, as measured by cTnI release, when compared with placebo, in patients undergoing interventional cardiology procedures.


METHODS
A single-blind, randomized controlled trial.


METHODS
A university hospital.


METHODS
Thirty patients undergoing stenting procedures (May 2005) were included in the present study.


METHODS
The authors randomly assigned 16 patients to breathe sevoflurane (expired end-tidal concentration 1%) and 14 patients to breathe a placebo oxygen/air mix before stenting procedures.


RESULTS
Postprocedural cardiac troponin I release was measured as a marker of myocardial necrosis. Sixteen patients had detectable cardiac troponin I levels after stenting procedures, with no difference between groups: 10 in the sevoflurane group (16 patients) versus 6 in the placebo group (14 patients) (p = 0.3). No difference in the amount of postprocedural median (interquartile range) cardiac troponin I release was noted between the sevoflurane group, 0.15 (0-4.73) ng/mL, and the placebo group, 0.14 (0-0.87) ng/mL (p = 0.4).


CONCLUSIONS
Myocardial damage measured by cardiac troponin release was not reduced by the volatile anesthetic sevoflurane during interventional cardiology procedures in this study.
Landoni
Giovanni
G
Department of Cardiothoracic Anesthesia and Intensive Care, Università Vita-Salute San Raffaele e Istituto Scientifico San Raffaele, Milan, Italy. landoni.giovanni@hsr.it
Zangrillo
Alberto
A
Fochi
Oliviero
O
Maj
Giulia
G
Scandroglio
Anna Mara
AM
Morelli
Andrea
A
Tritapepe
Luigi
L
Montorfano
Matteo
M
Colombo
Antonio
A
D000368:Aged; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008738:Methyl Ethers / Q000008:administration & dosage; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology / Q000517:prevention & control; D019990:Perioperative Care / Q000009:adverse effects / Q000295:instrumentation; D000077149:Sevoflurane; D016037:Single-Blind Method; D015607:Stents; D014835:Volatilization
D018685:Anesthetics, Inhalation; D002316:Cardiotonic Agents; D008738:Methyl Ethers; D000077149:Sevoflurane