Meta-analysis of protective effect of sevoflurane on myocardium during cardiac surgery

R. Xu, R. Lu, H. Jiang, Q.-f. Li, Y. Sun, H. Xu, Y. Huang

Department of Anesthesiology, Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China. hongjianga@hotmail.com

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• Anesthesiology

BACKGROUND: This study aims to evaluate the effect of sevoflurane anesthesia on myocardium in cardiac surgery and provide evidence for clinical anesthesia practice.

MATERIALS AND METHODS: Literature about the protective effect of sevoflurane anesthesia on myocardium in cardiac surgery published before March, 2012 was retrieved from the database of PubMed and EMBASE. The quality of inclusive randomized controlled trials was evaluated and screened according to the Jadad scale. Finally, meta-analysis was performed by using the RevMan5.0 software.

RESULTS: In this research, there were totally 17 articles in accordance with the inclusive criteria and all of them were in English with the study sites being abroad. Each article was more than 3 points in Jadad scale. Compared with total intravenous anesthesia group, postoperative 12h CO and CI of patients have been significantly improved in the sevoflurane anesthesia group; and concentration of postoperative 24 h cTnI in the sevoflurane anesthesia group has been reduced, as well as assisted respiratory time and ICU stay after operation. There is no significant difference in hospitalization stay between both groups; postoperative usage of vasoactive drugs in sevoflurane anesthesia group is less than in total intravenous anesthesia group. There is no significant difference in postoperative appearance of atrial fibrillation, recurrence rate of angina pectoris and mortality of patients after operation between both groups.

CONCLUSIONS: Sevoflurane can better protect myocardium in the cardiac surgery.

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