Inhaled anesthetics vs total IV anesthesia for CABG surgery

Editor's Note

In this study, having elective coronary artery bypass grafting (CABG) surgery under inhaled (ie, desflurane, isoflurane, or sevoflurane) anesthesia did not result in significantly fewer deaths than total intravenous (IV) anesthesia, though inhaled agents have cardioprotective effects.

A total of 5,400 patients at 36 centers in 13 countries were randomly assigned to inhaled (2,709 patients) or IV (2,691 patients) anesthesia.

There was no significant difference between the groups in deaths from any cause at 1 year (2.8%, inhaled vs 3.0%, IV). There also were no significant differences between groups for any of the secondary outcomes or incidence of adverse events, such as myocardial infarctions.

Previous studies have all suggested that the use of inhaled anesthetics during CABG surgery would enhance myocardial protection and reduce the risk of perioperative myocardial infarction, myocardial dysfunction, and death, the researchers note.