Purpose of the review: The present review addresses clinicians and gives an overview about the experimental rationale for pharmacological conditioning associated with volatile anesthetics, opioids, and propofol; the current clinical data; and the technical considerations regarding the clinical routine in cardiac anesthesia.
Recent findings: Volatile anesthetics have been standard of care for general anesthesia for cardiac surgery, especially while using cardiopulmonary bypass. The 2019 published MYRIAD trial was not able to show a difference in mortality or cardiac biomarkers for volatile anesthetics compared to total intravenous anesthesia (TIVA), raising the question of equivalence with respect to patient outcome.
Summary: Reviewing the literature, the scientific foundation for the belief of clinically relevant conditioning by uninterrupted administration of a volatile anesthetic is weak. TIVA can also be performed safely in patients undergoing cardiac surgery.
Keywords: Cardiac surgery; Desflurane; Propofol; Sevoflurane; Total intravenous anesthesia; Volatile anesthetics.
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021.