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Di Pumpo et al. Vessel Plus 2018;2:41 Vessel Plus
DOI: 10.20517/2574-1209.2018.38

Review Open Access

Volatile anesthetics in cardiac surgery: the
impalpable benefit

Annalaura Di Pumpo, Chiara Candela, Fabrizio Cucciniello, Domenico Sarubbi, Felice Eugenio Agrò
Department of Anesthesia and Intensive Care Unit, Università Campus Bio-Medico di Roma, Rome 00128, Italy.

Correspondence to: Dr. Annalaura Di Pumpo, Department of Anesthesia and Intensive Care Unit, Università Campus Bio-
Medico di Roma, Via Alvaro del Portillo 200, Rome 00128, Italy. E-mail: a.dipumpo@unicampus.it

How to cite this article: Di Pumpo A, Candela C, Cucciniello F, Sarubbi D, Agrò FE. Volatile anesthetics in cardiac surgery: the
impalpable benefit. Vessel Plus 2018;2:41. http://dx.doi.org/10.20517/2574-1209.2018.38

Received: 29 May 2018 First Decision: 17 Oct 2018 Revised: 5 Nov 2018 Accepted: 5 Nov 2018 Published: 12 Dec 2018
Science Editors: Mario F. L. Gaudino, Cristiano Spadaccio Copy Editor: Cui Yu Production Editor: Huan-Liang Wu

Abstract
Nowadays, there are numerous studies demonstrating that volatile anesthetics reduce mortality and morbidity with a
cardio-protective effect. The mechanisms involved in protecting perioperative cardiac ischemic damage provided by
desflurane and sevoflurane are not fully known. Volatile anesthetics are commonly used in cardiac surgery. This mini-
review aims to summarize the mechanism of action for cardio-protection of volatile anesthetics and discuss the potential
therapeutic implications. Human studies have shown that volatile anesthetics can reduce mortality, but also the use
of mechanical ventilation in cardiac patients, especially coronary artery bypass grafting. In contrast, total intravenous
anesthesia has not shown any significant benefit compared to halogenated agents. Volatile anesthetics are among
the few drugs that affect survival in the perioperative period. In addition, they can be administered in areas other than
cardiac surgery due to their cardioprotective effects, which may add future perspectives in their use.

Keywords: Volatile anesthetics, preconditioning, cardiac surgery, cardio-protection

INTRODUCTION
Nowadays, there are numerous studies demonstrating that volatile anesthetics reduce mortality and morbid-
[1]
ity with a cardio-protective effect . The mechanisms involved in protecting perioperative cardiac ischemic
damage provided by desflurane and sevoflurane are not fully known.

In 1986, for the first time, this phenomenon is described as a response to short periods of sublethal ischemia
[2]
leading to a protection against a subsequent lethal ischemia .

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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