A randomized, controlled trial.
A teaching hospital.
Eighty-eight consecutive patients undergoing noncardiac surgery.
Patients were allocated randomly to receive either volatile anesthetic (44 patients) as the main anesthetic agent or total intravenous anesthesia (TIVA) (44 patients).
Postoperative cardiac troponin I release was measured as a marker of myocardial necrosis. Patients with detectable postoperative troponin I in the sevoflurane group (12/44, 27.3 % ) were similar to those in the propofol group (9/44, 20.5 % ; p = 0.6). There was no significant reduction of postoperative median peak cTnI release (0.16 ¡À 0.71 ng/mL in the sevoflurane group compared with the TIVA group, 0.03 ¡À 0.08 ng/mL; p = 0.4). Three patients died at the 1-year follow-up for noncardiac causes (2 in the TIVA group).
In the authors' experience, patients undergoing noncardiac surgery did not benefit from anesthesia based on halogenated anesthetics. Further studies are necessary to evaluate the cardioprotective effects of volatile agents in noncardiac surgery.