• J-H Baumert, M Hein, K E Hecker, S Satlow, P Neef, and R Rossaint.
• Klinik für Anaesthesiologie, Universitaetsklinikum Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany. jan.baumert@googlemail.com
• Br J Anaesth. 2008 May 1;100(5):605-11.

BackgroundThe results of two European multi-centre trials on xenon anaesthesia led to the hypothesis that a xenon-based anaesthetic would keep left ventricular (LV) and circulatory function more stable than a propofol-based anaesthetic, in patients with coronary artery disease (CAD).MethodsIn a prospective, randomized design, 40 patients of ASA classes III and IV with known CAD were anaesthetized for elective non-cardiac surgery with either xenon (n=20) or propofol (n=20), each combined with remifentanil. Target criteria were intraoperative LV function as evaluated by transoesophageal echocardiography (TOE: Tei index, circumferential fibre shortening), arterial pressure, and heart rate (HR).ResultsMean arterial pressure was decreased with propofol but was stable at pre-anaesthetic level with xenon (P<0.02) and HR was lower with xenon (P<0.01). The Tei index (also known as myocardial performance index) improved from 0.53 (0.14) to 0.45 (0.10) after 1 h with xenon and changed from 0.50 (0.14) to 0.55 (0.20) with propofol anaesthesia [means (SD); P=0.01 between the groups]. Deviation of circumferential fibre shortening from expected value after 1 h was -2 (14)% with xenon and -14 (18)% with propofol [means (SD); P=0.03]. There were no perioperative signs of acute myocardial ischaemia (TOE, ECG, and troponin T release).ConclusionsXenon anaesthesia provided a higher arterial pressure level than propofol, with no signs of cardiovascular compromise, in patients with CAD. Echocardiographic indices showed better LV function with xenon.

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