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Journal of Anesthesia

, Volume 30, Issue 6, pp 977–986 | Cite as

Sevoflurane preconditioning in on-pump coronary artery bypass grafting: a meta-analysis of randomized controlled trials

  • Yan Lu
  • Liwei Wang
  • Na Liu
  • Tianxin Dong
  • Ruhong Li
Original Article

Abstract

Purpose

Sevoflurane preconditioning (SevoPreC) has been proved to prevent organ ischemia/reperfusion (I/R) injury in various animal models and preclinical studies. Clinical trials on cardioprotection by SevoPreC for adult patients undergoing coronary artery bypass graft (CABG) revealed mixed results. The aim of this meta-analysis was to evaluate the cardiac effect of SevoPreC in on-pump CABG.

Methods

Randomized controlled trials (RCT) comparing the cardiac effect of SevoPreC (compared with control) in adult patients undergoing CABG were searched from PubMed, Embase, and the Cochrane Library (up to November 2015). The primary endpoints were postoperative troponin levels. Additional endpoints were CK-MB levels, mechanic ventilation (MV) duration, intensive care unit (ICU) stay, and hospital length of stay (LOS).

Results

Six trials with eight comparisons enrolling a total of 384 study patients reporting postoperative troponin levels were identified. Compared with controls, SevoPreC decreased postoperative myocardial troponin levels [standardized mean difference (SMD) = −0.38; 95 % CI, −0.74 to −0.03; P = 0.04; I 2 = 63.9 %]. However, no significant differences were observed in postoperative CK-MB levels [weighted mean difference (WMD) = −1.71; P = 0.37; I 2 = 37.7 %], MV duration (WMD = −0.53; P = 0.47; I 2 = 0.0 %), ICU stay (WMD = −0.91; P = 0.39; I 2 = 0.9 %), and hospital LOS (WMD = 0.08; P = 0.86; I 2 = 8.0 %).

Conclusion

Available evidence from the present systematic review and meta-analysis suggests that sevoflurane preconditioning may reduce troponin levels in on-pump CABG. Future high-quality, large-scale clinical trials should focus on the early and long-term clinical effect of SevoPreC in on-pump CABG.

Keywords

Sevoflurane preconditioning Cardioprotection Coronary artery bypass graft 

Notes

Acknowledgments

We thank Dr. Yang Liu, and Dr. Li Ma from Beijing Chest Hospital, for their language-editing assistance.

Compliance with ethical standards

Conflict of interest

None declared.

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Copyright information

© Japanese Society of Anesthesiologists 2016

Authors and Affiliations

  • Yan Lu
    • 1
  • Liwei Wang
    • 1
  • Na Liu
    • 1
  • Tianxin Dong
    • 1
  • Ruhong Li
    • 1
  1. 1.Department of AnesthesiologyAffiliated Hospital of Chengde Medical CollegeChengdeChina

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