Meta-analysis of the cardioprotective effect of sevoflurane versus propofol during cardiac surgery

BMC Anesthesiology

Research Article

Feng Li¹  Yuan Yuan² 

[1] Department of Anesthesia, First People’s Hospital, 224000, Yancheng, Jiangsu Province, China;Department of Otolaryngology, First People’s Hospital, 224000, Yancheng, Jiangsu Province, China;

关键词: Sevoflurane;    Propofol;    Cardiac surgery;    Cardioprotective effect;    Meta-analysis;   

DOI  :  10.1186/s12871-015-0107-8

 received in 2014-11-10, accepted in 2015-09-09,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundTo evaluate the cardioprotective effects of sevoflurane versus propofol anesthesia in patients undergoing cardiac surgery.MethodsStudies 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.ResultsAs 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.DiscussionThe 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.ConclusionsSevoflurane may exhibit a more favorable cardioprotective effect during cardiac surgery than propofol.

【 授权许可】

CC BY   
© Li and Yuan. 2015