Comparison of myocardial protection of sevoflurane versus propofol in patients undergoing coronary artery bypass grafting surgery: a Meta-analysis of randomized controlled trials / 中华麻醉学杂志

ABSTRACT

Objective Meta-analysis was performed to compare the myocardial protection of sevoflurane versus propofol in patients undergoing coronary artery bypass grafting (CABG) surgery. Methods Electronic databases were searched to identify all randomized controlled trials (RCTs) published to September 2008 which compared sevoflurane with propofol in patients undergoing CABG surgery. Two authors independently assessed the quality of each study to meet the inclusion criteria and extracted perioperative data, including patients' preoperative information (baseline characteristics, heart function, disease history and situation of medication), surgical variables (number of grafts and iachemia time) and outcome data such us cardiac index after CPB, postoperative cardiac troponin Ⅰ (cTnⅠ) levels, mechanical ventilation time, positive inotropic drugs, intensive care unit (ICU) and hospital stay length, postoperative mortality, myocardial infarction, myocardial ischemia and atrial fibrillation. Then Meta analysis was performed using RevMan 5.0 software. Results A total of 696 patients from 13 prospective RCTs were inchided in the Meta analysis, 402 out of 696 patients were allocated into sevoflurane group, and 294 into propofol group. There were no significant differences in postoperative mechanical ventilation time, usage rate of positive inotropic drugs, postoperative mortality, incidence of myocardial infarction and atrial fibrillation between the two groups ( P > 0.05 ). Cardiac index after CPB was significantly higher, postoperative cTnl level and incidence of postoperative myocardial ischernia lower, and ICU and hospital stay length shorter in the sevoflurane group than in the propofol group ( P < 0.05 ). Conclusion Sevoflunme has better myocardial protection than propofol in patients undergoing CABG surgery.