Inhaled Sevoflurane Compared to Intravenous Sedation Post Coronary Artery Bypass Grafting
Status:
Completed
Trial end date:
2008-12-01
Target enrollment:
Participant gender:
Summary
Inhaled sevoflurane during coronary artery bypass grafting (CABG) reduces postoperative
Troponin levels and may be associated with improved outcome. A dose-response effect has been
demonstrated by de Hert et al, with greatest reductions of Troponin when Sevoflurane was used
during the entire operation, as compared to Sevoflurane during parts of the operation.
Sevoflurane, as other inhaled anesthetic agents, is sedative in low doses. Postoperative
sedation after CABG is currently achieved with intravenous propofol.
A new simplified method of administration of isoflurane or sevoflurane has been developed and
tested by members of the research group. The Anesthetic Conserving Device is a modified
heat-moisture exchanger (HME) that permits direct infusion of sevoflurane to the airway,
where it is vaporized in an evaporator rod in the device.
The primary aim (and primary hypothesis)of the current trial is to examine if postoperative
sedation with sevoflurane after CABG is associated with improved cardiac outcome, measured as
reduced levels of Troponin, BNP and reduced incidence of cardiac events, such as atrial
fibrillation, need for inotropic drugs and myocardial infarction, compared with conventional
propofol sedation.
Other end-points of the trial are potential renal (protective) effects measured with cystatin
C levels, need for dialysis but also measurements of inorganic fluorides in serum, as well as
environmental aspects of sevoflurane sedation in a Cardiothoracic Intensive Care Unit.
Furthermore, potential differences in ICU memories and well-being during stay in the
intensive Care Unit will be investigated via patient questionnaires.
Besides routine blood sampling, plasma will be saved for later analysis of inflammatory
mediators (biobank).