Safe sedation management using volatile anesthetics during cardiopulmonary bypass

Several pieces of evidence suggest that volatile anesthetics (VAs), which were originally used as sedatives, have myocardial protective effects against cardiac ischemia–reperfusion injury. In Europe and the United States, the use of VAs during cardiopulmonary bypass (CPB) is widespread, as 2019 Euro...

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Bibliographic Details
Published inJournal of anesthesia Vol. 36; no. 2; pp. 287 - 293
Main Authors Tamura, Takahiro, Mori, Atsushi, Nishiwaki, Kimitoshi
Format Journal Article
LanguageEnglish
Published Singapore Springer Singapore 01.04.2022
Springer
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Summary:Several pieces of evidence suggest that volatile anesthetics (VAs), which were originally used as sedatives, have myocardial protective effects against cardiac ischemia–reperfusion injury. In Europe and the United States, the use of VAs during cardiopulmonary bypass (CPB) is widespread, as 2019 European Association for Cardio-Thoracic Surgery (EACTS)/European Association of Cardiothoracic Anaesthesiology/European Board of Cardiovascular Perfusion, 2011 American College of Cardiology/American Heart Association, and 2017 EACTS guidelines recommend their use in cardiovascular surgery, based on their potential myocardial protective effects. In other countries, including Japan, the use of VAs is gradually increasing. Therefore, it is important to be aware of the risks and possible adverse events associated with VA use during CPB to ensure safe sedation management. Herein, we describe in detail issues such as intraoperative awareness, air pollution, and damage to oxygenators due to VA use and propose precautions.
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ISSN:0913-8668
1438-8359
DOI:10.1007/s00540-022-03054-7