Cardioprotective effect of sevoflurane in patients undergoing heart surgery under cardiopulmonary bypass: A meta-analysis / 第二军医大学学报

ABSTRACT

Objective: To systematically review the cardioprotective of sevoflurane in patients undergoing heart surgery under cardiopulmonary bypass,so as to provide evidence for anesthesia decision of cardiac surgery. Methods: Trials about the cardioprotective effect of sevoflurane under CPB were collected through electronic search of Medline, CNKI, and CMBdisk (from the date of database establishment to October 2008); manual search was also conducted. Based on the inclusion and exclusion criteria, fourteen randomized-controlled trials were finally included in the present analysis. The details of the trial design, the characters of the subjects, and the results of the studies were reviewed and analyzed using RevMan 4.2 software. Results: The 14 trials involved 1226 patients, including 616 receiving sevoflurane and 610 receiving total intravenous anesthesia (TIVA). Compared with TIVA, our analysis showed the following results. (1) Cardiac function sevoflurane significantly increased the postoperative cardio index (CI, P < 0.01) and cardiac output (CO, P < 0.01). (2) Serum cTnI concentration at 24 h postoperation sevoflurane group was significantly lower than that of TIVA group (P < 0.01). (3) Sevoflurane significantly decreased the period of mechanical ventilation (P < 0.01) and the length of intensive care unit stay (P < 0.01), but the postoperative hospital stay was similar between the two groups. (4) The postoperative usage of inotropic agent was lower in sevoflurane group (P < 0.01). There were no significant differences in the mortality (P = 0.59), the incidence of atrial fibrillation (P = 0.11), and the myocardial infarction rate (P = 0.11) between the two groups. Conclusion: Sevoflurane has cardioprotective effect in patients undergoing heart surgery under CPB.