Home > Riviste > Minerva Anestesiologica > Fascicoli precedenti > Articles online first > Minerva Anestesiologica 2020 Mar 11

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo

 

 

Minerva Anestesiologica 2020 Mar 11

DOI: 10.23736/S0375-9393.20.14304-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Effect of volatile anesthetics on mortality and clinical outcomes in patients undergoing coronary artery bypass grafting: a meta-analysis of randomized clinical trials

YiNan ZHANG 1, 2, 3, Lei YANG 1, WenSheng ZHANG 1, 2, Jin LIU 1, 2

1 Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, PR China; 2 Laboratory of Anesthesia and Critical Care Medicine, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, PR China; 3 Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, PR China



INTRODUCTION: It remains unclear whether intraoperative use of volatile anesthetics has a positive effect on postoperative clinical outcomes in patients undergoing coronary artery bypass grafting (CABG). Therefore, we aimed to systematically analyze the long- and short-term mortality rates and the clinical outcomes of volatile anesthesia compared to those of total intravenous anesthesia (TIVA) in patients undergoing CABG.
EVIDENCE ACQUISITION: We queried the MEDLINE, Embase, and CENTRAL databases from inception to October 2019 for relevant randomized clinical trials (RCTs) on the intraoperative use of volatile anesthetics in patients undergoing CABG.
EVIDENCE SYNTHESIS: We pooled and analyzed 36 eligible RCTs with 10,308 patients and found that there was no significant difference in the long- and short-term mortality rate between the use of volatile anesthesia and TIVA during CABG. 30-day mortality, volatile group (39/2,824, 1.4%) vs TIVA group (35/2,786, 1.3%), RR=1.11, 95% CI [0.70, 1.74], P-value for effect = 0.66, I2 =0%, moderate-certainty evidence; One-year mortality, volatile group (77/2,749, 2.8%) vs TIVA group (78/2,731, 2.9%), RR=0.98, 95% CI [0.72, 1.34], P-value for effect = 0.90, I2 =0%, moderate- certainty evidence. Mechanical ventilation time was reduced in volatile group (MD -0.65, 95% CI [-1.07, -0.24], P-value for effect = 0.002, I2 = 26%).
CONCLUSIONS: There is no difference in the long- and short-term mortality and clinical outcomes between intraoperative use of volatile anesthetics and TIVA during CABG. However, volatile anesthetics may shorten the mechanical ventilation time. There is a need for high-quality multicenter RCTs that specifically assess factors that influence mortality and clinical outcomes.


KEY WORDS: Inhalation anaesthesia; Coronary artery bypass; Total intravenous anesthesia; Meta-analysis

inizio pagina