title: Is time to change to halogenated drugs in cardiac surgery, what do we have to do with propofol?
abstract: There is initial evidence, at least in cardiac surgery, that total intra-venous anesthesia (usually a propofol-based total intravenous anesthesia) is associated with an increased mortality when compared to an anesthetic plan including a halogenated anesthetics. The cardiac protective properties of halogenated agents (desflurane, isoflurane and sevoflurane) have not been confirmed in non-cardiac surgery and mixed results exist for patients admitted in postoperative intensive care units. This article summarizes the papers with the most impressive findings in favor of halogenated anesthetics, but it recognizes that, at the same time, there is no evidence based medicine against the use of propofol, highlighting the need for large randomized trials that should focus on survival.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Landoni
authors.forename: Laura
authors.initials: L
authors.lastname: Pasin
authors.forename: Giovanni
authors.initials: G
authors.lastname: Borghi
authors.affiliation: Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy. landoni.giovanni@hsr.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Zangrillo
mesh_terms: D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D000818:Animals; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000639:trends*; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D002986:Clinical Trials as Topic / Q000379:methods; D006801:Humans; D008738:Methyl Ethers / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D015742:Propofol / Q000008:administration & dosage*; D000077149:Sevoflurane; D013997:Time Factors
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D002316:Cardiotonic Agents; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol