Comparison Between the Protective Effect of Isoflurane and Propofol on Myocardium During Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

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  • Author(s): Bao Q;Bao Q; Lei M; Lei M; Xiao D; Xiao D; Xie J; Xie J
  • Source:
    Brazilian journal of cardiovascular surgery [Braz J Cardiovasc Surg] 2024 Apr 17; Vol. 39 (3), pp. e20210424. Date of Electronic Publication: 2024 Apr 17.
  • Publication Type:
    Meta-Analysis; Systematic Review; Journal Article; Review
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Brazilian Society of Cardiovascular Surgery Country of Publication: Brazil NLM ID: 101677045 Publication Model: Electronic Cited Medium: Internet ISSN: 1678-9741 (Electronic) Linking ISSN: 01027638 NLM ISO Abbreviation: Braz J Cardiovasc Surg Subsets: MEDLINE
    • Publication Information:
      Original Publication: São Paulo, SP, Brasil : Brazilian Society of Cardiovascular Surgery, [2015]-
    • Subject Terms:
      Propofol* ; Isoflurane* ; Anesthetics*; Humans ; Randomized Controlled Trials as Topic ; Coronary Artery Bypass ; Myocardium
    • Abstract:
      Objective: Intravenous non-volatile anaesthetics like propofol are commonly used in cardiac surgeries across several countries. Volatile anaesthetics like isoflurane may help in protecting the myocardium and minimize ischaemia-reperfusion injury. Hence, we did this review to compare the cardioprotective effect of isoflurane and propofol among patients undergoing coronary artery bypass grafting (CABG).
      Methods: We conducted a search in the databases Medical Literature Analysis and Retrieval System Online (or MEDLINE), Embase, PubMed Central®, ScienceDirect, Google Scholar, and Cochrane Library from inception until April 2021. We carried out a meta-analysis with random-effects model and reported pooled risk ratio (RR) or standardized mean difference (SMD) with 95% confidence interval (CI) depending on the type of outcome.
      Results: We analysed 13 studies including 808 participants. Almost all were low-quality studies. For cardiac index, the pooled SMD was 0.14 (95% CI: -0.22 to 0.50); for cardiac troponin I, pooled SMD was 0.10 (95% CI: -0.28 to 0.48). For mortality, the RR was 3.00 (95% CI: 0.32 to 28.43); for MI, pooled RR was 1.58 (95% CI: 0.59 to 4.20); and for inotropic drug use, pooled RR was 1.04 (95% CI: 0.90 to 1.21). For length of intensive care unit stay, the pooled SMD was 0.13 (95% CI: -0.29 to 0.55), while pooled SMD for mechanical ventilation time was -0.02 (95% CI: -0.54 to 0.51).
      Conclusion: Isoflurane did not have significant cardioprotective effect compared to propofol following CABG. Hence, the anaesthetists need to check some viable alternatives to manage these patients and reduce the rate of postoperative complications.
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    • Contributed Indexing:
      Keywords: Cardiac Surgery; Isoflurane; Meta-Analysis; Propofol; Troponin I
    • Accession Number:
      YI7VU623SF (Propofol)
      CYS9AKD70P (Isoflurane)
      0 (Anesthetics)
    • Publication Date:
      Date Created: 20240417 Date Completed: 20240418 Latest Revision: 20240419
    • Publication Date:
      20240419
    • Accession Number:
      PMC11020280
    • Accession Number:
      10.21470/1678-9741-2021-0424
    • Accession Number:
      38629941