Coronary Artery Disease Clinical Trial
Official title:
Comparison of Desflurane and Propofol Anesthesia for Off-Pump Coronary Artery Bypass Grafting Surgery
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
parameters:
1. hemodynamic parameters during and after the operation,
2. pulmonary gas exchange, need for mechanical ventilation and for ICU and intrahospital
stay,
3. release of heart muscle injury markers in response to surgery and intraoperative
ischaemia,
4. inflammatory response to the operation.
We suspect that insufflation anesthesia with desflurane may be superior to intravenous
anesthesia with propofol.
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
distal anastomoses.
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.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Supportive Care
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