title: Meta-analysis of the cardioprotective effect of sevoflurane versus propofol during cardiac surgery.
abstract: BACKGROUND
  To evaluate the cardioprotective effects of sevoflurane versus propofol anesthesia in patients undergoing cardiac surgery.
  
  
  METHODS
  Studies were retrieved through searching several databases. Study quality was evaluated by Jadad scale. Meta-analysis was performed with RevMan5.0 software. Publication bias was tested by funnel plot.
  
  
  RESULTS
  As a result, 15 studies were included. Compared with propofol, sevoflurane anesthesia significantly improved postoperative (WMD (weighted mean difference) = 0.62, 95% CI: 0.33 to 0.92; P < 0.0001) and postoperative 12 hour cardiac index (WMD = 0.18, 95% CI: 0.03 to 0.33; P = 0.02), postoperative cardiac output (WMD = 1.14, 95% CI: 0.74 to 1.54; P < 0.00001), and reduced postoperative 24 hour cardiac troponin I concentration (WMD = -0.86, 95% CI:-1.49 to -0.22; P = 0.008), postoperative inotropic drug usage (OR (odds ratio) = 0.31, 95% CI: 0.22 to 0.44; P < 0.00001), vasoconstrictor drug usage (OR = 0.30, 95% CI:0.21 to 0.43; P < 0.00001), ICU stay (WMD = -15.53, 95% CI: -24.29 to -6.58; P = 0.0007) and a trial fibrillation incidence (OR = 0.25, 95% CI: 0.07 to 0.85; P = 0.03). However, no significant differences were found in other indexes. Subgroup analysis indicated the similar results.
  
  
  CONCLUSIONS
  The sevoflurane-induced cTnI reduction is associated with lower incidence of late adverse cardiac events, accounting for its roles in cardiac protection. Several limitations existed such as the small sample size and the lack use of blind design.
  
  
  CONCLUSIONS
  Sevoflurane may exhibit a more favorable cardioprotective effect during cardiac surgery than propofol.
authors.affiliation: Department of Anesthesia, First People's Hospital, Yancheng, Jiangsu Province, 224000, China. lifenglifengllff@163.com.
authors.forename: Feng
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of Otolaryngology, First People's Hospital, Yancheng, Jiangsu Province, 224000, China. yuanyuanyydd@126.com.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yuan
mesh_terms: D018685:Anesthetics, Inhalation / Q000494:pharmacology; D018686:Anesthetics, Intravenous / Q000494:pharmacology; D001281:Atrial Fibrillation / Q000517:prevention & control; D002302:Cardiac Output / Q000187:drug effects; D006348:Cardiac Surgical Procedures; D002316:Cardiotonic Agents / Q000494:pharmacology*; D006331:Heart Diseases / Q000517:prevention & control*; D006801:Humans; D008738:Methyl Ethers / Q000494:pharmacology*; D011183:Postoperative Complications / Q000517:prevention & control*; D015742:Propofol / Q000494:pharmacology*; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D002316:Cardiotonic Agents; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol