Multicenter randomized comparison of xenon and isoflurane on left ventricular function in patients undergoing elective surgery.

TY - JOUR

T1 - Multicenter randomized comparison of xenon and isoflurane on left ventricular function in patients undergoing elective surgery.

AU - Wappler, Frank

AU - Rossaint, Rolf

AU - Baumert, Jan

AU - Scholz, Jens

AU - Tonner, Peter H

AU - van Aken, Hugo

AU - Berendes, Elmar

AU - Klein, Jan

AU - Gommers, Diederik

AU - Hammerle, Alfons

AU - Franke, Andreas

AU - Hofmann, Thomas

AU - Schulte Am Esch, Jochen

PY - 2007

Y1 - 2007

N2 - BACKGROUND: Volatile anesthetics are commonly used for general anesthesia. However, these can induce profound cardiovascular alterations. Xenon is a noble gas with potent anesthetic and analgesic properties. However, it is uncertain whether xenon alters myocardial function. The aim of this study was therefore to investigate left ventricular function during anesthesia with xenon compared with isoflurane. METHODS: The authors performed a randomized multicenter trial to compare xenon with isoflurane with respect to cardiovascular stability and adverse effects in patients without cardiac diseases scheduled for elective surgery. Two hundred fifty-nine patients were enrolled in this trial, of which 252 completed the study according to the protocol. Patients were anesthetized with xenon or isoflurane, respectively. Before administration of the study drugs and at four time points, the effects of both anesthetics on left ventricular function were investigated using transesophageal echocardiography. RESULTS: Global hemodynamic parameters were significantly altered using isoflurane (P <0.05 vs. baseline), whereas xenon only decreased heart rate (P <0.05 vs. baseline). In contrast to xenon, left ventricular end-systolic wall stress decreased significantly in the isoflurane group (P <0.05 vs. baseline). Velocity of circumferential fiber shortening was decreased significantly in the xenon group but showed a more pronounced reduction during isoflurane administration (P <0.05 vs. baseline). The contractile index (difference between expected and actually measured velocity of circumferential fiber shortening) as an independent parameter for left ventricular function was significantly decreased after isoflurane (P <0.0001) but unchanged using xenon. CONCLUSIONS: Xenon did not reduce contractility, whereas isoflurane decreased the contractile index, indicating that xenon enables favorable cardiovascular stability in patients without cardiac diseases.

AB - BACKGROUND: Volatile anesthetics are commonly used for general anesthesia. However, these can induce profound cardiovascular alterations. Xenon is a noble gas with potent anesthetic and analgesic properties. However, it is uncertain whether xenon alters myocardial function. The aim of this study was therefore to investigate left ventricular function during anesthesia with xenon compared with isoflurane. METHODS: The authors performed a randomized multicenter trial to compare xenon with isoflurane with respect to cardiovascular stability and adverse effects in patients without cardiac diseases scheduled for elective surgery. Two hundred fifty-nine patients were enrolled in this trial, of which 252 completed the study according to the protocol. Patients were anesthetized with xenon or isoflurane, respectively. Before administration of the study drugs and at four time points, the effects of both anesthetics on left ventricular function were investigated using transesophageal echocardiography. RESULTS: Global hemodynamic parameters were significantly altered using isoflurane (P <0.05 vs. baseline), whereas xenon only decreased heart rate (P <0.05 vs. baseline). In contrast to xenon, left ventricular end-systolic wall stress decreased significantly in the isoflurane group (P <0.05 vs. baseline). Velocity of circumferential fiber shortening was decreased significantly in the xenon group but showed a more pronounced reduction during isoflurane administration (P <0.05 vs. baseline). The contractile index (difference between expected and actually measured velocity of circumferential fiber shortening) as an independent parameter for left ventricular function was significantly decreased after isoflurane (P <0.0001) but unchanged using xenon. CONCLUSIONS: Xenon did not reduce contractility, whereas isoflurane decreased the contractile index, indicating that xenon enables favorable cardiovascular stability in patients without cardiac diseases.

M3 - SCORING: Zeitschriftenaufsatz

VL - 106

SP - 463

EP - 471

JO - ANESTHESIOLOGY

JF - ANESTHESIOLOGY

SN - 0003-3022

IS - 3

M1 - 3

ER -