Desflurane-induced Myocardial Protection

Study Overview
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Brief Summary
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This study examines pharmacological preconditioning and post conditioning of desflurane by comparing cardiac troponin release in patients receiving either desflurane or propofol for the aortic valve surgery.

Detailed Description
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Patients scheduled for aortic valve replacement with use of cardiopulmonary bypass are included in the study. Patients are assigned to desflurane group (Des) or propofol group (Prop). Des receives desflurane (1-2 MAC) inhalation between the induction of anesthesia and cardiopulmonary bypass (CPB). After the induction of CPB, the anesthesia in Des is switched to a total intravenous anesthesia (TIVA) with propofol. Prop receives a TIVA during the surgery. All patients receive a continuous infusion of remifentanil. Biomarker of myocardial damage troponin I is examined at 4 points; T1: after the induction of anesthesia, T2: arrival at ICU, T3: 12 hours after the ICU arrival, T4: 24 hours after the ICU arrival, T5: third post operative day (3POD).

Official Title
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Desflurane-induced Myocardial Protection in Aortic Valve Surgery: A Pilot Study

Conditions
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Aortic Valve Stenosis

Intervention / Treatment
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* Drug: Desflurane


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients scheduled for aortic valve replacement with use of cardiopulmonary bypass. Exclusion Criteria: Patients younger than 20 years old. Recent myocardial infarction (within 1 year). Renal dysfunction (GFR less than 50ml/min). Known allergy to study drugs including propofol.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Desflurane<br>Desflurane inhalation at 1-2 MAC during surgery. | Drug: Desflurane<br>* Patients are assigned to desflurane group (Des) or propofol group (Prop). Des receives desflurane (1-2 MAC) inhalation between the induction of anesthesia and before cardiopulmonary bypass (CPB). After the induction of CPB, the anesthesia in Des is switched to a total intravenous anesthesia (TIVA) with propofol. Prop receives a propofol during the surgery.<br>* Other names: SUPRANE;|
| Active Comparator: Propofol<br>5-8 mg/kg/hr infusion during surgery. | Drug: Desflurane<br>* Patients are assigned to desflurane group (Des) or propofol group (Prop). Des receives desflurane (1-2 MAC) inhalation between the induction of anesthesia and before cardiopulmonary bypass (CPB). After the induction of CPB, the anesthesia in Des is switched to a total intravenous anesthesia (TIVA) with propofol. Prop receives a propofol during the surgery.<br>* Other names: SUPRANE;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Troponin I |  | up to 3 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of ICU stay, Length of hospital stay |  | up to 2 months after the surgery | 
| Acute myocardial infarction |  | up to 7 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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aortic valve replacement