Is Time To Change To Halogenated Drugs In Cardiac Surgery, What Do We Have To Do With Propofol?
Landoni Giovanni, Pasin Laura, Borghi Giovanni and Zangrillo AlbertoAffiliation:
Anesthesia and Intensive Care Department, San Raffaele Scientific Institute Via Olgettina 60, Milan, 20132
AbstractThere is initial evidence, at least in cardiac surgery, that total intra-venous anesthesia (usually a propofol-based total intra-venous anesthesia) is associated with an increased mortality when compared to an anesthetic plan including an 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.
Anesthesia, cardiac surgery, mortality, propofol, halogenated agents, desflurane, isoflurane, sevoflurane
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