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Meta-analysis of the cardioprotective effect of sevoflurane versus propofol during cardiac surgery
BACKGROUND: To evaluate the cardioprotective effects of sevoflurane versus propofol anesthesia in patients undergoing cardiac surgery. METHODS: Studies were retrieved through searching several databases. Study quality was evaluated by Jadad scale. Meta-analysis was performed with RevMan5.0 software....
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2015
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4583176/ https://www.ncbi.nlm.nih.gov/pubmed/26404434 http://dx.doi.org/10.1186/s12871-015-0107-8 |
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author | Li, Feng Yuan, Yuan |
author_facet | Li, Feng Yuan, Yuan |
author_sort | Li, Feng |
collection | PubMed |
description | BACKGROUND: To evaluate the cardioprotective effects of sevoflurane versus propofol anesthesia in patients undergoing cardiac surgery. METHODS: Studies were retrieved through searching several databases. Study quality was evaluated by Jadad scale. Meta-analysis was performed with RevMan5.0 software. Publication bias was tested by funnel plot. RESULTS: As a result, 15 studies were included. Compared with propofol, sevoflurane anesthesia significantly improved postoperative (WMD (weighted mean difference) = 0.62, 95% CI: 0.33 to 0.92; P < 0.0001) and postoperative 12 hour cardiac index (WMD = 0.18, 95% CI: 0.03 to 0.33; P = 0.02), postoperative cardiac output (WMD = 1.14, 95% CI: 0.74 to 1.54; P < 0.00001), and reduced postoperative 24 hour cardiac troponin I concentration (WMD = -0.86, 95% CI:-1.49 to -0.22; P = 0.008), postoperative inotropic drug usage (OR (odds ratio) = 0.31, 95% CI: 0.22 to 0.44; P < 0.00001), vasoconstrictor drug usage (OR = 0.30, 95% CI:0.21 to 0.43; P < 0.00001), ICU stay (WMD = -15.53, 95% CI: -24.29 to -6.58; P = 0.0007) and a trial fibrillation incidence (OR = 0.25, 95% CI: 0.07 to 0.85; P = 0.03). However, no significant differences were found in other indexes. Subgroup analysis indicated the similar results. DISCUSSION: The sevoflurane-induced cTnI reduction is associated with lower incidence of late adverse cardiac events, accounting for its roles in cardiac protection. Several limitations existed such as the small sample size and the lack use of blind design. CONCLUSIONS: Sevoflurane may exhibit a more favorable cardioprotective effect during cardiac surgery than propofol. |
format | Online Article Text |
id | pubmed-4583176 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-45831762015-09-26 Meta-analysis of the cardioprotective effect of sevoflurane versus propofol during cardiac surgery Li, Feng Yuan, Yuan BMC Anesthesiol Research Article BACKGROUND: To evaluate the cardioprotective effects of sevoflurane versus propofol anesthesia in patients undergoing cardiac surgery. METHODS: Studies were retrieved through searching several databases. Study quality was evaluated by Jadad scale. Meta-analysis was performed with RevMan5.0 software. Publication bias was tested by funnel plot. RESULTS: As a result, 15 studies were included. Compared with propofol, sevoflurane anesthesia significantly improved postoperative (WMD (weighted mean difference) = 0.62, 95% CI: 0.33 to 0.92; P < 0.0001) and postoperative 12 hour cardiac index (WMD = 0.18, 95% CI: 0.03 to 0.33; P = 0.02), postoperative cardiac output (WMD = 1.14, 95% CI: 0.74 to 1.54; P < 0.00001), and reduced postoperative 24 hour cardiac troponin I concentration (WMD = -0.86, 95% CI:-1.49 to -0.22; P = 0.008), postoperative inotropic drug usage (OR (odds ratio) = 0.31, 95% CI: 0.22 to 0.44; P < 0.00001), vasoconstrictor drug usage (OR = 0.30, 95% CI:0.21 to 0.43; P < 0.00001), ICU stay (WMD = -15.53, 95% CI: -24.29 to -6.58; P = 0.0007) and a trial fibrillation incidence (OR = 0.25, 95% CI: 0.07 to 0.85; P = 0.03). However, no significant differences were found in other indexes. Subgroup analysis indicated the similar results. DISCUSSION: The sevoflurane-induced cTnI reduction is associated with lower incidence of late adverse cardiac events, accounting for its roles in cardiac protection. Several limitations existed such as the small sample size and the lack use of blind design. CONCLUSIONS: Sevoflurane may exhibit a more favorable cardioprotective effect during cardiac surgery than propofol. BioMed Central 2015-09-24 /pmc/articles/PMC4583176/ /pubmed/26404434 http://dx.doi.org/10.1186/s12871-015-0107-8 Text en © Li and Yuan. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Li, Feng Yuan, Yuan Meta-analysis of the cardioprotective effect of sevoflurane versus propofol during cardiac surgery |
title | Meta-analysis of the cardioprotective effect of sevoflurane versus propofol during cardiac surgery |
title_full | Meta-analysis of the cardioprotective effect of sevoflurane versus propofol during cardiac surgery |
title_fullStr | Meta-analysis of the cardioprotective effect of sevoflurane versus propofol during cardiac surgery |
title_full_unstemmed | Meta-analysis of the cardioprotective effect of sevoflurane versus propofol during cardiac surgery |
title_short | Meta-analysis of the cardioprotective effect of sevoflurane versus propofol during cardiac surgery |
title_sort | meta-analysis of the cardioprotective effect of sevoflurane versus propofol during cardiac surgery |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4583176/ https://www.ncbi.nlm.nih.gov/pubmed/26404434 http://dx.doi.org/10.1186/s12871-015-0107-8 |
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