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Table 2 Studies including anaesthetics agents

From: Myocardial conditioning techniques in off-pump coronary artery bypass grafting

Mroziński et al. (2014) Anaesthesiol Intensive Ther, Poland [40] Prospective randomized open-label trial Sixty OPCAB 28 Propofol 32 Desflurane DES PP Assessment of hemodynamic function and myocardial injury markers DES group demonstrated improved stability, expressed as LVSWI; no differences in myocardial injury in between groups No difference reported between DES and PP in major haemodynamic parameters, myocardial injury markers and the long-term outcome; DES might accelerate LVSWI recovery
Orriach et al. (2013) J Crit Care, Spain [25] Prospective randomized trial Sixty OPCAB SS and PP (intra-op and post op as postconditioning) BNP Troponin release Need for inotropic drugs SS group had reduced BNP, troponin release and number of inotropic drugs Compared to S-P and P-P groups SS administration in OR and CICU, decreased troponin release compared with SS intra-op, but both were a better option to decrease troponin level when compared to PP
Sevoflurane/Sevoflurane (S-S)
20 Sevoflurane/Propofol (S-P) 20 Propofol/Propofol (P-P)
Wang et al. (2013) Scand Cardiovasc J, China [26] Prospective randomized controlled trial Forty-eight OPCAB SS BNP SS significantly decreased post-surgical troponin levels No significant differences in BNP level among groups SS exerted significant myocardial protective effect; BNP could not predict myocardial protective effect of SS in OPCAB
20 Sevoflurane   Troponin release
20 Control
Suryaprakash et al. (2013) Ann Card Anaesth, India [28] Prospective randomized trial One hundred thirty SS Troponin release Changes in troponin levels at all time intervals were comparable in the three groups No difference found in myocardial protection with SS or DES or PP
48 Sevoflurane PP
52 Desflurane
39 Propofol
Tempe et al. (2011) J Cardiothorac Vasc Anesth, India [38] Prospective randomized trial Forty-five OPCAB ISO Troponin release Troponin release in the PP group was significantly higher than the ISO group at 6 and 24 hours after surgery ISO provided protection against myocardial damage by lowering levels of troponin-T
Isoflurane PP
Ballester et al. (2011) Eur J Anaesthesiol, Spain [33] Prospective controlled randomized trial Thirty-eight OPCAB SS Markers of lipoperoxidation (F2-isoprostanes) and nitrosative stress (nitrates/nitrites) measured in coronary sinus blood F2-isoprostanes concentrations were significant lower in the SS group at all different time point SS showed better antioxidative properties than PP
20 Sevoflurane PP
18 Propofol
Kim et al. (2011) Anaesth Intensive Care, Korea [29] Prospective randomized controlled trial Ninety-four OPCAB SS CK MB and troponin release No statistically differences in between groups in terms of CK-MB and troponin release at different end points SS and PP had similar CK-MB and troponin values
47 Sevoflurane PP
47 Propofol (both in a remifentanil based anesthesia)
Hammerling et al. (2010) Ann Card Anaesth Canada [34] Prospective double blinded trial Forty OPCAB SS Incidence of arrhythmias Supraventricular tachycardia occurred only in the DES-group, AF was significantly more frequent in the DES group versus SEVO-group SS found to be more advantageous than DES, as it was associated with less AF or supraventricular arrhythmias
20 Sevoflurane DES
20 Desflurane
Xu (2009) J South Med Univ, China [42] Prospective controlled randomized trial Twenty four OPCAB REMI Troponin release Statistically significant reduction of troponin level in the REMI group Troponin levels of REMI preconditioning group were markedly decreased after the operation in comparison with those of the control group
12 Remifentanil
12 Control
Drenger et al. (2008) Journal of Cardiothoracic and Vascular Anesthesia, Israel [21] Prospective controlled randomized trial Twenty five OPCAB IP induced with single 5 min LAD occlusion followed by 5 min reperfusion 1.6% ENF started 15 min before LAD occlusion Myocardial metabolism Lactate production in the ENF group decreased significantly compared with control and IP groups. Oxygen utilization in the control group was 44% higher than the other two groups Early recovery of anterior wall hypokinesis in both study groups Application of methods such as IP or volatile anesthesia appeared to reduce the metabolic deficit
8 Control
9 IP
8 Enflurane
Hemmerling (2008) European Journal of Anaesthesiology, Canada [31] Prospective randomised trial Fourty OPCAB SS Troponin/CK-MB No differences in terms of enzymes release, heart contractility and haemodynamic values Extubation time was significantly shorter with SS compared to ISO SS and ISO provided the same ischaemic cardio-protective effects; SEVO allowed a more rapid recovery from anaesthesia
20 Sevoflurane ISO LVWM abnormalities time to extubation/respiratory functions haemodynamic parameters
20 Isoflurane
Huseidzinović et al. (2007) Croat Med J, Croatia [35] Prospective randomised controlled trial 32 OPCABG SS Acceleration of aortic blood flow, CI, HR, mean arterial pressure, and central venous pressure at different time points SS group showed better CI values at the beginning of ischemia and 15 minutes after ischemia; in the PP group acceleration decreased and remained lower 15 minutes after sternal closure while was increased in the SS group Cardiac function was better preserved in patients with SS than with PP
16 Sevoflurane
16 Control
Venkatesh et al. (2007) Ann Card Anaesth, India [32] Prospective randomized Forty OPCAB SS Haemodynamic effects amount of analgesia needed postoperative recovery No differences identified in terms of haemodynamic parameters, depth of anesthesia, and quantity of agent needed; time of awakening and subsequent extubation were significantly less with SS SS and ISO could both safely used in OPCAB; awakening and extubation time were significantly lower with SS.
20 Isoflurane ISO
20 Sevoflurne
Lucchinetti et al. (2007) Anesthesiology, Switzerland [37] Prospective randomised trial 20 OPCAB SS Troponin, NBP and associate pregnancy-associated plasma protein A release Gene expression profile (atrial biopsies) NPB and protein A were decrease in SS group; Echo showed preserved post-op LV function in SS group. SS gene regulatory control of myocardial substrate metabolism predicted postoperative cardiac function in OPCAB patients
10 Propofol PP
10 Sevoflurane
Guarracino et al. (2006) Journal of Cardiothoracic and Vascular Anesthesia, Italy [41] Prospective randomised trial One hundred twelve DES Troponin release Post-op peak troponin was significantly lower in DES group Myocardial damage measured by cardiac troponin release could be reduced by DES during OPCAB
57 Desflurane (in addition to opiate-based anesthesia)
55 Propofol
Law-Koune (2006) J Cardiothorac Vasc Anesth, France [30] Prospective randomized trial Eighteen OPCAB SS-REMI Troponin release No difference in troponin release Study did not support cardio-protective effects of SS
9 Sevoflurane-remifentanil PP-REMI
9 Propofol-remifentanil
Bein et al. (2005) Anesth Analg, Germany [43] Prospective randomized trial Fifty-two OPCAB (MIDCAB) SS Myocardial function Myocardial performance index and early to atrial filling velocity ratio in the PP group deteriorated significantly whereas there was no change in the SS group In patients undergoing MIDCAB surgery, SS preserved myocardial function better than PP
26 Sevoflurane PP
26 Propofol  
Kendall (2004) Anaesthesia, UK [39] Prospective randomized trial Thirty OPCAB PP Troponin release No significant difference in between groups No support of ISO as cardioprotective agent was reported
10 Propofol ISO
10 Isoflurane ISO/high thoracic epidural analgesia
10 Isoflurane and high thoracic epidural analgesia
Conzen et al. (2003) Anesthesiology, Germany [27] Prospective randomized trial Twenty OPCAB SS Troponin release Troponin increased significantly more in the PP group rather than in the SS group Patients receiving SS had less myocardial injury during the first 24 post-op hours than patients with PP
10 Sevoflurane
10 Propofol
  1. AF: Atrial fibrillation; BNP: Brain natriuretic peptide ONCAB: On pump Coronary Artery By-pass Grafting; OPCAB: Off pump Coronary Artery By-pass Grafting; DES: Desflurane IP: Ischemic preconditioning; LAD: Left anterior descending artery; LVWMS: Left ventricle wall motion score; MIDCAB: Minimally invasive direct coronary artery bypass grafting; PostC: Postconditioning; SS: Sevoflurane.