A Comparison of Two Anaesthetic Methods of Protecting Heart Tissue During Cardiac Surgery

• Status: Unknown status
• Trial end date: 2008-01-01
• Target enrollment: 0
• Participant gender: All

Summary

To compare two different methods of protecting heart muscle from damage caused by a decreased blood supply. Exposure to the anaesthetic agent sevoflurane can allow the heart muscle to resist longer periods of low blood or oxygen supply without sustaining the amount of damage that it would otherwise expect to. The use of thoracic epidural analgesia improves the blood flow to the heart muscle and has also been shown to reduce the amount of damage the heart muscle may otherwise sustain. The aim of this study is to compare these two methods.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Golden Jubilee National Hospital
• Collaborator: European Society for Intravenous Anaesthesia
• Treatments: Anesthetics; Sevoflurane

Criteria

Inclusion Criteria:

• Patients presenting for elective CABG operations, with >40 % left ventricular ejection fraction, aged 40-80.

Exclusion Criteria:

• Patients at risk of epidural haematomas (i.e. platelets <100, coagulopathies, on anticoagulant therapies, INR>1.4) or unsuited to HTEA (patient refusal, spinal deformities).

Patients on drugs shown to manipulate the preconditioning phenomenon will also be excluded. This includes those on diazoxide, nicorandil, oral sulfonylureas and theophyllines.

Patients with preoperative ECG morphologies likely to make interpretation difficult or impossible including: left bundle branch block, cardiac pacemaker dependence.

Haemodynamically compromised patients requiring inotropic or balloon pump support preoperatively.

Significant valvular disease. Preoperative elevated levels of troponin I or CKMB. Unstable angina or angina in 24 hours preop