Total Intravenous Anesthesia Is Preferred Over Volatile Agents

J. Cardiothorac. Vasc. Anesth. · Oct 2024

Review Comparative Study

Total Intravenous Anesthesia Is Preferred Over Volatile Agents in Cardiac Surgery.

The choice of maintenance anesthetic during cardiopulmonary bypass has been a subject of ongoing debate. Systematic reviews on the topic have so far failed to demonstrate a difference between volatile agents and total intravenous anesthesia (TIVA) in terms of mortality, myocardial injury, and neurological outcomes. Studies using animal models and noncardiac surgical populations suggest numerous mechanisms whereby TIVA has been associated with more favorable outcomes. However, even if the different anesthetic methods are assumed to equivalent in terms of patient outcomes in the context of cardiac surgery, additional factors, namely variables of occupational exposure and environmental impact, strongly support the preferred use of TIVA.

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- Alan M Smeltz and Ricardo A Serrano.
- University of North Carolina School of Medicine, Chapel Hill, NC. Electronic address: alan_smeltz@med.unc.edu.
- J. Cardiothorac. Vasc. Anesth. 2024 Oct 1; 38 (10): 247724812477-2481.
AbstractThe choice of maintenance anesthetic during cardiopulmonary bypass has been a subject of ongoing debate. Systematic reviews on the topic have so far failed to demonstrate a difference between volatile agents and total intravenous anesthesia (TIVA) in terms of mortality, myocardial injury, and neurological outcomes. Studies using animal models and noncardiac surgical populations suggest numerous mechanisms whereby TIVA has been associated with more favorable outcomes. However, even if the different anesthetic methods are assumed to equivalent in terms of patient outcomes in the context of cardiac surgery, additional factors, namely variables of occupational exposure and environmental impact, strongly support the preferred use of TIVA.Copyright © 2024 Elsevier Inc. All rights reserved.

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Total Intravenous Anesthesia Is Preferred Over Volatile Agents in Cardiac Surgery.

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