Early Cardioprotective Effect of Sevoflurane
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Purpose
In vitro studies and in vivo animal experiments have shown that halogenated volatile anesthetics have a protective effect on the ischemic myocardium. In clinical settings however, anesthetic preconditioning may be of more interest. The aim of our study was to evaluate the cardioprotective effect of sevoflurane in patients undergoing off-pump coronary artery bypass surgery. We proposed that a cardioprotective effect of sevoflurane would save myocardial function, which we measured acceleration by esophageal Doppler and cardiac index with bolus thermodilution methods, both during brief ischemia and reperfusion.
| Condition | Intervention | Phase |
|---|---|---|
|
Coronary Artery Disease Off Pump Coronary Artery Bypass Surgery |
Drug: Sevoflurane Drug: propofol |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind Primary Purpose: Treatment |
| Official Title: | Early Cardioprotective Effect of Sevoflurane on Left Ventricular Performance During Coronary Artery Bypass Grafting on a Beating Heart |
- To evaluate cardiac function with measuring of hemodynamic parameters [ Time Frame: Measurements were performed at the following intervals: 5 minutes after anesthesia induction; at the beginning of ischemia; 15 minutes after ischemia; 15 minutes after sternum closure ]
| Enrollment: | 32 |
| Study Start Date: | August 2006 |
| Study Completion Date: | December 2006 |
Studies have been performed on human patients undergoing CABG surgery with cardiopulmonary bypass (CPB). Only a few studies however have evaluated the effects of volatile anesthetics during coronary artery bypass grafting on a beating heart (OPCABG) with conflicting results as far as cardiac biomarker release is concerned.
Because CPB is known to have a profound impact on cardiac function, studies performed on patients scheduled for OPCABG could evaluate more specifically the effects of the anesthetic agents themselves. Patients undergoing OPCABG have a predictable and predefined ischemic zone during surgery and represent an extremely interesting and safe model for the study of ischemia and cardiac damage in humans.
Presently, there is still no consensus on the method of administration of volatile anesthetics, including the time to begin administration, its duration, the dosage and selection of volatile anesthetics.
Eligibility| Ages Eligible for Study: | 40 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- the degree I or II of Cardiac Anesthesia Risk Evaluation score
- angiographically verified coronary artery disease
- left ventricular ejection fraction higher than 40%
Exclusion Criteria:
- atrioventricular conduction disturbances
- previously ventricular arrhythmias requiring antiarrhythmic treatment
- atrial fibrillation with rapid ventricular response
- myocardial infarction or stroke within 6 months
- diabetes mellitus
- end-stage of obstructive or restrictive pulmonary disease
Contacts and Locations| Croatia | |
| University Hospital Dubrava | |
| Zagreb, Croatia, 10000 | |
| Principal Investigator: | Ino Husedzinovic, MD PhD Prof | Anesthesiology and Intensive Medicine |
More Information
No publications provided by University Hospital Dubrava
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| ClinicalTrials.gov Identifier: | NCT00477737 History of Changes |
| Other Study ID Numbers: | CARPRO10 |
| Study First Received: | May 22, 2007 |
| Last Updated: | May 23, 2007 |
| Health Authority: | Croatia: Ministry of Health and Social Care |
Keywords provided by University Hospital Dubrava:
|
cardioprotection sevoflurane esophageal Doppler thermodilution coronary artery bypass |
Additional relevant MeSH terms:
|
Coronary Artery Disease Myocardial Ischemia Coronary Disease Heart Diseases Cardiovascular Diseases Arteriosclerosis Arterial Occlusive Diseases Vascular Diseases Propofol Sevoflurane Anesthetics, Intravenous |
Anesthetics, General Anesthetics Central Nervous System Depressants Physiological Effects of Drugs Pharmacologic Actions Central Nervous System Agents Therapeutic Uses Hypnotics and Sedatives Platelet Aggregation Inhibitors Hematologic Agents Anesthetics, Inhalation |
ClinicalTrials.gov processed this record on May 16, 2013