Organ protection by volatile anesthetics in non-coronary artery bypass grafting surgery.
The cardioprotective properties of volatile anesthetics have been widely demonstrated by numerous randomized studies and meta-analyses in the setting of cardiac surgery, above of all during coronary artery bypass grafting procedures. Recently, conflicting results have been presented in cardiac non-coronary artery bypass grafting surgery. Unfortunately, despite the existence of a great number of studies comparing a total intravenous anesthetic regimen with an inhalational regimen, at present there are no randomized studies presenting data regarding mortality and important outcomes, such as myocardial infarction, in non-cardiac surgery. In this review we analyze and present the results of the most recent and important studies regarding anesthetic preconditioning in cardiac and in noncardiac surgery. Furthermore, we focus on the emerging data from animal experiments, discussing in particular the molecular mechanisms underlying anesthetic preconditioning.
Landoni
Giovanni
G
Department of Cardiothoracic Anesthesia and Intensive Care, Istituto Scientifico San Raffaele, Milano, Italy. landoni.giovanni@hsr.it
Turi
Stefano
S
Bignami
Elena
E
Zangrillo
Alberto
A
D000572:American Heart Association; D018685:Anesthetics, Inhalation; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000601:surgery; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial; D008738:Methyl Ethers; D009206:Myocardium; D017410:Practice Guidelines as Topic; D000077149:Sevoflurane; D015607:Stents; D016896:Treatment Outcome; D014481:United States; D055549:Volatile Organic Compounds
D018685:Anesthetics, Inhalation; D002316:Cardiotonic Agents; D008738:Methyl Ethers; D055549:Volatile Organic Compounds; D000077149:Sevoflurane