title: A comparative study of pharmacological myocardial protection between sevoflurane and desflurane at anaesthestic doses in patients undergoing off pump coronary artery bypass grafting surgery.
abstract: OBJECTIVE
  Perioperative myocardial ischaemia (PMI) is one of the known complications during off pump coronary artery bypass (OPCAB) surgeries. The length of hospital stay is considerably prolonged in patients with PMI. Myocardial protection is an area which is being widely researched currently to prevent or reduce the incidence of PMI. Over the last decade it has become clear that volatile anaesthetic agents are protective in the setting of PMI and reperfusion. Hence, we planned to study the effect of two different volatile anaesthetics as myocardial protective agents in OPCAB surgery.
  
  
  METHODS
  A total of 40 patients were enrolled for the study; Group A (sevoflurane, n = 20) and Group B (desflurane, n = 20). All patients had a baseline measurement of Trop-T, creatine phosphokinase-MB (CPKMB) and myocardial performance index (MPI) pre-operatively, which was repeated 4 h after the surgery. Chi-square/Fisher test was used to find the significance of the differences between the two agents.
  
  
  RESULTS
  Patients were comparable in demographic, baseline, biochemical and echo criteria. Post-operative CPKMB levels (desflurane - 30.85 ± 2.69 u/L; sevoflurane - 29.05 ± 5.26 u/L, P = 0.7) and number of Trop-T positive patients (Sevoflurane - 9; desflurane - 6, P ≥ 0.05) were comparable. Post-operative MPI indicated decreased left ventricular function in sevoflurane group as compared to desflurane group (P ≤ 0.03).
  
  
  CONCLUSIONS
  Desflurane exerts better cardioprotective effect than sevoflurane as indicated by better MPI in OPCAB surgeries.
authors.affiliation: Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
authors.forename: Umesh
authors.initials: U
authors.lastname: Sivanna
authors.affiliation: Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
authors.forename: Shreedhar
authors.initials: S
authors.lastname: Joshi
authors.affiliation: Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
authors.forename: Balaji
authors.initials: B
authors.lastname: Babu
authors.affiliation: Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
authors.forename: A M
authors.initials: AM
authors.lastname: Jagadeesh
keywords: Creatine phosphokinase; desflurane; myocardial performance index; myoglobin; perioperative myocardial ischemia; sevoflurane; troponin T