The Impact of Anesthetic Regimen on Outcomes in Adult Cardiac Surgery: A Narrative Review

J Cardiothorac Vasc Anesth. 2021 Mar;35(3):711-729. doi: 10.1053/j.jvca.2020.03.054. Epub 2020 Apr 20.

Abstract

Despite improvements in surgical techniques and perioperative care, cardiac surgery still is burdened by relatively high mortality and frequent major postoperative complications, including myocardial dysfunction, pulmonary complications, neurologic injury, and acute kidney injury. Although the surgeon's skills and volume and patient- and procedure-related risk factors play a major role in the success of cardiac surgery, there is growing evidence that also optimizing perioperative care may improve outcomes significantly. The present review focuses on the aspects of perioperative care that are strictly related to the anesthesia regimen, with special reference to volatile anesthetics and neuraxial anesthesia, whose effect on outcome in adult cardiac surgery has been investigated extensively.

Keywords: anesthesia; cardiac anesthesia; cardiac surgery; coronary artery bypass grafting; sevoflurane.

Publication types

  • Review

MeSH terms

  • Adult
  • Anesthesia* / adverse effects
  • Anesthetics, Inhalation*
  • Cardiac Surgical Procedures* / adverse effects
  • Humans
  • Perioperative Care
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control

Substances

  • Anesthetics, Inhalation