• Br J Anaesth · Aug 2024

    Randomized Controlled Trial Multicenter Study Comparative Study

    Effect of volatile versus propofol anaesthesia on major complications and mortality after cardiac surgery: a multicentre randomised trial.

    • Xiao-Qian Deng, Hong Yu, Wei-Jian Wang, Qiao-Lin Wu, Hua Wei, Jing-Song Deng, Zhi-Jian Li, Jin-Zheng Wu, Jian-Jun Yang, Xiang-Ming Zheng, Jin-Ju Wei, Shuai-Shuai Fan, Xiao-Hua Zou, Jing Shi, Fang-Xiang Zhang, Da-Qing Wu, Dang-Pei Kou, Tao Wang, E Wang, Zhi Ye, Xing Zheng, Gang Chen, Wen-Qi Huang, Yu Chen, Xin Wei, Xiao-Qing Chai, Wei-Qin Huang, Ling Wang, Kai Li, Liang Li, Ye Zhang, Rui Li, Jia-Li Jiao, Hai Yu, and Jin Liu.
    • Department of Anaesthesiology, West China Hospital, Sichuan University, Chengdu, China.
    • Br J Anaesth. 2024 Aug 1; 133 (2): 296304296-304.

    BackgroundThe comparative effectiveness of volatile anaesthesia and total intravenous anaesthesia (TIVA) in terms of patient outcomes after cardiac surgery remains a topic of debate.MethodsMulticentre randomised trial in 16 tertiary hospitals in China. Adult patients undergoing elective cardiac surgery were randomised in a 1:1 ratio to receive volatile anaesthesia (sevoflurane or desflurane) or propofol-based TIVA. The primary outcome was a composite of predefined major complications during hospitalisation and mortality 30 days after surgery.ResultsOf the 3123 randomised patients, 3083 (98.7%; mean age 55 yr; 1419 [46.0%] women) were included in the modified intention-to-treat analysis. The composite primary outcome was met by a similar number of patients in both groups (volatile group: 517 of 1531 (33.8%) patients vs TIVA group: 515 of 1552 (33.2%) patients; relative risk 1.02 [0.92-1.12]; P=0.76; adjusted odds ratio 1.05 [0.90-1.22]; P=0.57). Secondary outcomes including 6-month and 1-yr mortality, duration of mechanical ventilation, length of ICU and hospital stay, and healthcare costs, were also similar for the two groups.ConclusionsAmong adults undergoing cardiac surgery, we found no difference in the clinical effectiveness of volatile anaesthesia and propofol-based TIVA.Clinical Trial RegistrationChinese Clinical Trial Registry (ChiCTR-IOR-17013578).Copyright © 2024 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

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