Volatile versus total intravenous anesthesia for 30-day mortality following non-cardiac surgery in patients with preoperative myocardial injury
- Authors
- Park, J[Park, Jungchan]; Lee, SH[Lee, Seung-Hwa]; Lee, JH[Lee, Jong-Hwan]; Min, JJ[Min, Jeong Jin]; Kwon, JH[Kwon, Ji-Hye]; Oh, AR[Oh, Ah-Ran]; Carriere, K[Carriere, Keumhee]; Ahn, J[Ahn, Joonghyun]
- Issue Date
- 11-Sep-2020
- Publisher
- PUBLIC LIBRARY SCIENCE
- Citation
- PLOS ONE, v.15, no.9
- Indexed
- SCIE
SCOPUS
- Journal Title
- PLOS ONE
- Volume
- 15
- Number
- 9
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/3168
- DOI
- 10.1371/journal.pone.0238661
- ISSN
- 1932-6203
- Abstract
- We evaluated whether volatile anesthetics can improve the postoperative outcomes of non-cardiac surgery in patients with preoperative myocardial injury defined by the cardiac troponin elevation. From January 2010 to June 2018, 1254 adult patients with preoperative myocardial injury underwent non-cardiac surgery under general anesthesia and were enrolled in this study. Patients were stratified into following two groups according to anesthetic agents; 115 (9.2%) patients whose anesthesia was induced and maintained with continuous infusion of propofol and remifentanil (TIVA group) and 1139 (90.8%) patients whose anesthesia was maintainted with volatile anesthetics (VOLATILE group). The primary outcome was 30-day mortality. To diminish the remifentanil effect, a further analysis was conducted after excluding the patients who received only volatile anesthetics without remifentanil infusion. In a propensity-score matched analysis, 30-day mortality was higher in the TIVA group than the VOLATILE group (17.0%vs. 9.1%; hazard ratio [HR] 2.60; 95% confidence interval [CI], 1.14-5.93;p= 0.02). In addition, the TIVA group showed higher 30-day mortality than the VOLATILE group, even after eliminating the effect of remifentanil infusion (15.8%vs. 8.3%; HR 4.62; 95% CI, 1.82-11.74;p= 0.001). In our study, the use of volatile anesthetics showed the significant survival improvement after non-cardiac surgery in patients with preoperative myocardial injury, which appears to be irrelevant to the remifentanil use. Further studies are needed to confirm this beneficial effect of volatile anesthetics.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - Medicine > Department of Medicine > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.