Volatile anesthetics for periprocedural cardiac protection: A review

G. Landoni, O. Fochi O, E. Bignami, F. De Simone, A. Zangrillo

Research output: Contribution to journalArticle


All volatile anesthetics have cardiac depressant effects that decrease myocardial oxygen demand and may, therefore, have a beneficial role on the myocardial oxygen balance during ischemia. Recently, experimental evidence has clearly demonstrated that in addition to these indirect protective effects, volatile anesthetic agents also have direct protective properties against ischemic myocardial damage. The implementation of these properties during clinical anesthesia can provide an additional tool in the treatment or prevention, or both, of ischemic cardiac dysfunction in the perioperative period. A recent meta-analysis showed that desflurane and sevoflurane reduce postoperative mortality and incidence of myocardial infarction following cardiac surgery with significant advantages in terms of postoperative cardiac troponin release, need for inotrope support, time on mechanical ventilation, intensive care unit and overall hospital stay. Multicenter, randomized clinical trials had previously demonstrated that the use of desflurane can reduce the postoperative release of cardiac troponin I, the need for inotropic support, and the number of patients requiring prolonged hospitalization, following coronary artery bypass graft surgery, either with and without cardiopulmonary bypass. Evidence in non-coronary surgical settings is contradictory and will be reviewed in this paper together with the mechanism of cardiac protection by volatile agents.

Original languageEnglish
Pages (from-to)429-434
Number of pages6
JournalMinerva Cardioangiologica
Issue number4
Publication statusPublished - Aug 2008


  • Anesthetics, inhalation
  • Desflurane
  • Mortality
  • Myocardial ischemia, prevention and control
  • Sevoflurane

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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