Desflurane Versus Sevoflurane and Postoperative Cardiac Biomarkers in Older Adults Undergoing Low- to Moderate-Risk Noncardiac Surgery-Secondary Analysis of a Prospective, Observer-Blinded, Randomized Clinical Trial

被引：0

作者：

Taschner, Alexander ^{[1
]}

Reiterer, Christian ^{[1
]}

Fleischmann, Edith ^{[1
]}

Kabon, Barbara ^{[1
]}

Horvath, Katharina ^{[1
]}

Adamowitsch, Nikolas ^{[1
]}

Emler, David ^{[1
]}

Christian, Thomas ^{[1
]}

Hantakova, Nicole ^{[1
]}

Hochreiter, Beatrix ^{[1
]}

Hoefer, Laura ^{[1
]}

List, Magdalena ^{[1
]}

Rossi, Barbara ^{[1
]}

Zenz, Florian W. ^{[1
]}

Zanvettor, Giulia ^{[1
]}

Zotti, Oliver ^{[1
]}

Fraunschiel, Melanie ^{[2
]}

Graf, Alexandra ^{[3
]}

机构：

[1] Med Univ Vienna, Dept Anesthesia Intens Care Med & Pain Med, Spitalgasse 23, A-1090 Vienna, Austria

[2] Med Univ Vienna, IT Serv & Strat Informat Management, Spitalgasse 23, A-1090 Vienna, Austria

[3] Med Univ Vienna, Inst Med Stat, Ctr Med Data Sci, Spitalgasse 23, A-1090 Vienna, Austria

来源：

JOURNAL OF CLINICAL MEDICINE | 2024年 / 13卷 / 19期

关键词：

desflurane; sevoflurane; cardiac biomarkers; NT-proBNP; troponin T; copeptin; low- to moderate-risk noncardiac surgery; older adults; MEDIATED SYMPATHETIC ACTIVATION; MYOCARDIAL INJURY; COPEPTIN CONCENTRATIONS; PREOPERATIVE COPEPTIN; INCREMENTAL VALUE; ASSOCIATION; ANESTHESIA; ISOFLURANE; VOLATILE; EVENTS;

D O I：

10.3390/jcm13195946

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background/Objectives: Previous preclinical studies have shown that desflurane might have the most significant cardioprotective effect of all volatile anesthetics. However, data regarding the cardioprotective effects of desflurane versus sevoflurane are lacking. Therefore, we evaluated the effect of the maintenance of anesthesia using desflurane versus sevoflurane on the postoperative maximum concentrations of cardiac biomarkers in older adults undergoing low- to moderate-risk noncardiac surgery. Methods: In this secondary analysis of a prospective randomized trial, we included all 190 older adults undergoing low- to moderate-risk noncardiac surgery. Patients were randomized to receive desflurane or sevoflurane for the maintenance of anesthesia. We administered desflurane or sevoflurane, aiming at a BIS value of 50 +/- 5. The cardiac-specific biomarkers included troponin T, NT-proBNP, and copeptin, which were measured preoperatively, within one hour after surgery, and on the second postoperative day. Results: There were no significant differences between the desflurane and sevoflurane groups in the postoperative maximum concentrations of troponin T (11 ng.L-1 [8; 16] versus 13 ng.L-1 [9; 18]; p = 0.595), NT-proBNP (196 pg.mL(-1) [90; 686] versus 253 pg.mL(-1) [134; 499]; p = 0.288), or copeptin (19 pmol.L-1 [7; 58] versus 12 pmol.L-1 [6; 41]; p = 0.096). We also observed no significant differences in the troponin T, NT-proBNP, or copeptin concentrations between the desflurane and sevoflurane groups at any measured timepoint (all p > 0.05). Conclusions: In contrast to preclinical studies, we did not observe a significant difference in the postoperative maximum concentrations of cardiac biomarkers. It seems likely that desflurane does not exert significant clinical meaningful cardioprotective effects in older adults. Thus, our results do not support the use of desflurane in patients undergoing low- to moderate-risk noncardiac surgery.

引用

页数：14

共 32 条

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