Cardiothoracic and Vascular Anesthesia

Cognitive function after sevoflurane- vs propofol-based anaesthesia for on-pump cardiac surgery: a randomized controlled trial

Schoen J, Husemann L, Tiemeyer C, et al (Univ of Luebeck, Germany) Br J Anaesth 106:840-850, 2011^§

Abstract

Background

Cognitive dysfunction is a frequent complication after cardiac surgery and has been found to be associated with decreases in cerebral oxygen saturation (Sco₂) measured with near-infrared spectroscopy. Sevoflurane has neuroprotective properties in vitro and in animal models. This study was designed to determine cognitive and clinical outcomes after sevoflurane- compared with propofol-based anaesthesia for on-pump cardiac surgery and the impact of decreases in Sco₂ under different anaesthesia regimens.

Methods

One hundred and twenty-eight patients were randomly as-signed to either i.v. anaesthesia with propofol- (PROP) or sevoflurane-based anaesthesia (SEVO). An intraoperative Sco₂ <50% was defined as desaturation. The Abbreviated Mental Test, Stroop Test, Trail-Making Test, Word Lists, and mood-assessment tests were performed before, 2, 4, and 6 days after cardiac surgery. Markers of general outcome were obtained.

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