Sevoflurane and Isoflurane - During Cardiopulmonary Bypass With the MECC System (Minimized Extracorporeal Circuit)
Status:
Completed
Trial end date:
2014-01-01
Target enrollment:
Participant gender:
Summary
The use of volatile anesthetics in cardiac anesthesia is very common, because of their
cardioprotective effects and their ability to ensure a sufficient depth of anesthesia. In
line with the development of fast track concepts in cardiac anesthesia, volatile anesthetics
are widely used to avoid a delayed recovery from cardiac surgery and anesthesia. Volatile
anesthetics are delivered from calibrated vaporizers in the anesthesia machine or the
cardiopulmonary bypass machine (during extracorporeal circulation).
Isoflurane and Sevoflurane are the most commonly used volatile anesthetics in patients
undergoing cardiopulmonary bypass (CPB). The vaporizer of the anesthetics is on the
cardiopulmonary bypass machine and the volatile agent is blended with air and oxygen. Until
now, the pharmacokinetics of halothane, enflurane, isoflurane and desflurane during CPB have
been described.
Sevoflurane might be of advantage because of additional myocardial protective effects during
cardiac anesthesia and cardiopulmonary bypass. However, the pharmacokinetics of sevoflurane
during CPB have not been investigated so far, although its being used at many hospitals.
The investigators will conduct a randomized prospective study with either sevoflurane or
isoflurane during cardiopulmonary bypass surgery. The study will help to answer the questions
about the possible cardioprotective effects of the widely used volatile anesthetics and the
hemodynamic stability during cardiopulmonary bypass. Knowing the pharmacokinetics of these
drugs allows the anesthesiologist to titrate the volatile anesthetics more precise.
The investigators hypothesizes that the maximal postoperative increase in troponin T will be
smaller in the sevoflurane group than in the isoflurane group. The investigators hypothesizes
that the total amount of noradrenaline needed during the entire period of cardiopulmonary
bypass will be smaller in the sevoflurane group than in the isoflurane group. The
investigators hypothesizes that kinetics of washin and washout at the CPB will be faster in
the sevoflurane group than in the isoflurane group. The investigators hypothesizes that the
time to extubation, respectively the length of stay in intensive care unit and hospital is
shorter in the sevoflurane group than in the isoflurane group.
Phase:
Phase 4
Details
Lead Sponsor:
University Hospital, Basel, Switzerland
Collaborators:
Penn State University RWTH Aachen University University of Leipzig