• Lei-Lei He, Xue-Fei Li, Jia-Li Jiang, Hong Yu, Shun-Hui Dai, Wei-Wei Jing, and Hai Yu.
• Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China; Department of Anesthesiology, Sichuan Jinxin Women and Children's Hospital, Chengdu, China.
• J. Cardiothorac. Vasc. Anesth. 2022 Oct 1; 36 (10): 3758-3765.

ObjectivesThe purpose of this study was to evaluate the effect of volatile anesthesia and propofol-based total intravenous anesthesia (TIVA) on postoperative pulmonary complications (PPCs) among patients undergoing cardiac surgery.DesignParallel-group, randomized controlled trial.SettingSingle-center tertiary care hospital.ParticipantsFive hundred twenty-four patients undergoing cardiac surgery with cardiopulmonary bypass.InterventionsThe patients were assigned randomly (1:1) to receive anesthesia maintenance with a volatile anesthetic (sevoflurane or desflurane) or propofol-based TIVA.Measurements And Main ResultsThe primary outcome was a composite of postoperative pulmonary complications within the first 7 postoperative days. The PPCs occurred in 118 of 262 patients (45.0%) in the volatile anesthesia group compared with 105 of 262 patients (40.1%) in the propofol-based intravenous anesthesia group (relative risk: 1.17 [95% CI 0.96-1.42], p = 0.123). There were no significant differences in the severity of PPCs within 7 days postoperatively, the occurrence and severity grade of PPCs within 30 days, the incidence of hypoxia, and 30-day mortality.ConclusionsIn adult patients undergoing cardiac surgery with cardiopulmonary bypass, general anesthesia with a volatile anesthetic compared with propofol-based TIVA had not reduced pulmonary complications within the first 7 days after surgery.Copyright © 2022 Elsevier Inc. All rights reserved.

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