Continuous Versus Repetitive Sevoflurane Administration for Preconditioning

Study Overview
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Brief Summary
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Pharmacologic preconditioning by volatile anesthetics may depend on the mode of administration. The researchers hypothesize that a continuous administration in patients scheduled for CABG surgery prebypass will be less effective in terms of attenuating myocardial cell damage compared to a repetitive administration with a double wash in/wash out schedule. A control group will receive propofol as their primary anesthetic.

Official Title
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A Comparison Between Continuous and Repetitive Sevoflurane Administration for Preconditioning During Coronary Artery Bypass Surgery

Conditions
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Myocardial Injury

Intervention / Treatment
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* Drug: Sevoflurane


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients schedulded to undergo CABG surgery Age 18 to 80 years Ejection fraction > 40% Exclusion Criteria: Emergency cases Diabetes Not able to give informed consent Ejection fraction < 40%

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 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 |
| --- | --- |
| Active Comparator: Group 1<br>Propofol as the primary anesthetic | Drug: Sevoflurane<br>* 1 MAC Sevoflurane will be given either continuously after induction of anesthesia until initiation of cardiopulmonary bypass or will be repetitively washed in and out twice before initiation of cardiopulmonary bypass.<br>|
| Experimental: Group 2<br>Sevoflurane administered continuously after induction of anesthesia until initiation of cardiopulmonary bypass. | Drug: Sevoflurane<br>* 1 MAC Sevoflurane will be given either continuously after induction of anesthesia until initiation of cardiopulmonary bypass or will be repetitively washed in and out twice before initiation of cardiopulmonary bypass.<br>|
| Experimental: Group 3<br>Sevoflurane administered repetitive up to 1 MAC from induction of anesthesia until initiation of cardiopulmonary bypass. Wash in and wash out performed twice. | Drug: Sevoflurane<br>* 1 MAC Sevoflurane will be given either continuously after induction of anesthesia until initiation of cardiopulmonary bypass or will be repetitively washed in and out twice before initiation of cardiopulmonary bypass.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Myocardial cell damage as assessed by plasma levels of Troponin T |  | from induction of anesthesia until hospital discharge | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of stay on the ICU and in the hospital |  | from hospital admission until hospital discharge | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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myocardial protection, pharmacological preconditioning, volatile anesthetics, myocardial injury following CABG surgery