Volatile anaesthetics and cardiac protection in abdominal surgery.

BACKGROUND: Clinical studies have shown that sevoflurane is cardio-protective in cardiac surgery patients, but this effect is doubtful in general surgery patients. This study has researched the influence of sevoflurane on the perioperative cardiac function and the incidence of cardiac ischaemic events in abdominal surgical patients.

METHODS: Out of 80 patients scheduled for elective colorectal surgery, 42 received balanced sevoflurane-fentanyl anaesthesia, while 38 received intravenous midazolam-fentanyl anaesthesia. The cardiac index (CI) and cardiac function index (CFI) were measured by the PiCCO device, and Troponin I levels were measured at the beginning of surgery, as well as 4, 12 and 24 h afterwards. BNP was measured at the beginning of surgery, and 24 h afterwards. The data analysis was conducted using the Mann-Whitney nonparametric test, with statistical significance set at p < 0.05.

RESULTS: There was no statistical difference in perioperative Troponin I, BNP, CI and CFI values between the SEVO and TIVA groups throughout the perioperative period.

CONCLUSIONS: Sevoflurane had no effect on the cardiac biomarkers Troponin I and BNP, and on the PiCCO parameters of cardiac function in abdominal surgical patients. Further research on the preconditioning effect of volatile anaesthetics in general surgical population should be concentrated on the population of patients with a high perioperative cardiac risk.