Desflurane Versus Propofol Anesthesia for Off-Pump CABG
Information source: Medical University of Gdansk
Information obtained from ClinicalTrials.gov on June 20, 2008
Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Coronary Artery Disease
Intervention: Diprivan (propofol), Astra-Zeneca (Drug); Suprane (desflurane), Baxter (Drug)
Phase: Phase 4
Sponsored by: Medical University of Gdansk
Official(s) and/or principal investigator(s):
Romuald Lango, M.D., Ph.D., Study Director, Affiliation: Medical University of Gdańsk, Department of Cardiac Anesthesiology
The purpose of this study is to prove if anesthesia maintained with the inhaled volatile
anesthetic desflurane is superior to the intravenously applied propofol anesthesia in
off-pump coronary artery bypass grafting (OP-CABG) surgery as measured by following
1. hemodynamic parameters during and after the operation,
2. pulmonary gas exchange, need for mechanical ventilation and for ICU and intrahospital
3. release of heart muscle injury markers in response to surgery and intraoperative
4. inflammatory response to the operation.
We suspect that insufflation anesthesia with desflurane may be superior to intravenous
anesthesia with propofol.
Official title: Comparison of Desflurane and Propofol Anesthesia for Off-Pump Coronary Artery Bypass Grafting Surgery
Study design: Supportive Care, Randomized, Single Blind (Subject), Active Control, Parallel Assignment, Safety/Efficacy Study
Primary outcome: Markers of heart muscle injury and inflammation will be compared: troponin I, creatinine phosphokinase and its heart specific fraction, C-reactive protein.
Secondary outcome: Evidence of clinically definite heart infarct confirmed by ECG and/or echocardiography, and heart muscle specific creatinine phosphokinase increase.
General anesthesia will be induced by intravenous dosis of fentanyl, vecuronium and etomidate
and further maintained either by inhaled desflurane or propofol infusion, with concomitant
empirically administered fentanyl doses and continuous infusion of vecuronium.
After induction of anesthesia a Swan-Ganz catheter for continuous cardiac output, right
ventricle end diastolic volume and blood saturation measurements will be introduced through
the internal jugular vein. A transesophageal echocardiography probe will be placed
additionally for the Tei-index measurement.
Hemodynamic parameters will be recorded at the following time points:
- before induction
- after induction
- during trachea intubation
- before skin incision
- 3 Min. after skin incision
- after sternotomy
- before heart positioning for graft placing
- before finishing placing each distal anastomoses
- 10, 20, 30, 40 min after placing the last anastomoses
- 10 Min. after admission to ICU, 6, 12, 18 and 24 hours after surgery.
- TEE measurements will be obtained after sternotomy and 20 Min after placing the last
The results will be compared while using the parametric ANOVA test for normally distributed
continuous data or the nonparametric Kruskal-Wallis/Wilcoxon-U test for categoric or
inhomogeneous distributed continuous data.
Minimum age: 18 Years.
Maximum age: 75 Years.
- Patients with coronary artery disease qualified for CABG off-pump surgery
- Elective surgery
- Signed informed consent
- Left ventricle ejection fraction < 30%
- Serum creatinine > 2 mg/dL
- Emergency surgery
- Denied consent
Locations and Contacts
Department of Cadiac Anesthesiology, Medical University of Gdańsk, Gdańsk 80-211, Poland
Xia Z, Luo T. Sevoflurane or desflurane anesthesia plus postoperative propofol sedation attenuates myocardial injury after coronary surgery in elderly high-risk patients. Anesthesiology. 2004 Apr;100(4):1038-9; author reply 1039-40. No abstract available.
Tritapepe L, Landoni G, Guarracino F, Pompei F, Crivellari M, Maselli D, De Luca M, Fochi O, D'Avolio S, Bignami E, Calabro MG, Zangrillo A. Cardiac protection by volatile anaesthetics: a multicentre randomized controlled study in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass. Eur J Anaesthesiol. 2007 Apr;24(4):323-31. Epub 2006 Dec 8.
Guarracino F, Landoni G, Tritapepe L, Pompei F, Leoni A, Aletti G, Scandroglio AM, Maselli D, De Luca M, Marchetti C, Crescenzi G, Zangrillo A. Myocardial damage prevented by volatile anesthetics: a multicenter randomized controlled study. J Cardiothorac Vasc Anesth. 2006 Aug;20(4):477-83.
De Hert SG, Cromheecke S, ten Broecke PW, Mertens E, De Blier IG, Stockman BA, Rodrigus IE, Van der Linden PJ. Effects of propofol, desflurane, and sevoflurane on recovery of myocardial function after coronary surgery in elderly high-risk patients. Anesthesiology. 2003 Aug;99(2):314-23.
Starting date: February 2007
Ending date: March 2008
Last updated: May 15, 2008