Effects of Volatile Anesthetics on Postoperative Ischemic Stroke Incidence.
Anesthesia, General
/ adverse effects
Anesthetics, Inhalation
/ adverse effects
Desflurane
/ adverse effects
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Humans
Incidence
Ischemic Stroke
/ diagnosis
Isoflurane
/ adverse effects
Male
Massachusetts
/ epidemiology
Middle Aged
Postoperative Complications
/ diagnosis
Pulmonary Alveoli
/ drug effects
Retrospective Studies
Severity of Illness Index
Sevoflurane
/ adverse effects
Volatilization
anesthetics
cerebral ischemia
retrospective studies
stroke
stroke prevention
Journal
Journal of the American Heart Association
ISSN: 2047-9980
Titre abrégé: J Am Heart Assoc
Pays: England
ID NLM: 101580524
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
pubmed:
27
2
2021
medline:
15
10
2021
entrez:
26
2
2021
Statut:
ppublish
Résumé
Background Preclinical studies suggest that volatile anesthetics decrease infarct volume and improve the outcome of ischemic stroke. This study aims to determine their effect during noncardiac surgery on postoperative ischemic stroke incidence. Methods and Results This was a retrospective cohort study of surgical patients undergoing general anesthesia at 2 tertiary care centers in Boston, MA, between October 2005 and September 2017. Exclusion criteria comprised brain death, age <18 years, cardiac surgery, and missing covariate data. The exposure was defined as median age-adjusted minimum alveolar concentration of all intraoperative measurements of desflurane, sevoflurane, and isoflurane. The primary outcome was postoperative ischemic stroke within 30 days. Among 314 932 patients, 1957 (0.6%) experienced the primary outcome. Higher doses of volatile anesthetics had a protective effect on postoperative ischemic stroke incidence (adjusted odds ratio per 1 minimum alveolar concentration increase 0.49, 95% CI, 0.40-0.59,
Identifiants
pubmed: 33634705
doi: 10.1161/JAHA.120.018952
pmc: PMC8174248
doi:
Substances chimiques
Anesthetics, Inhalation
0
Sevoflurane
38LVP0K73A
Desflurane
CRS35BZ94Q
Isoflurane
CYS9AKD70P
Types de publication
Comparative Study
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e018952Subventions
Organisme : NINDS NIH HHS
ID : R01 NS109174
Pays : United States
Organisme : NHLBI NIH HHS
ID : UG3 HL140177
Pays : United States
Références
Pharm Stat. 2011 Mar-Apr;10(2):150-61
pubmed: 20925139
Lancet. 1991 Jun 22;337(8756):1521-6
pubmed: 1675378
Anaesthesia. 2013 May;68(5):512-22
pubmed: 23414556
J Clin Anesth. 1997 Sep;9(6 Suppl):18S-22S
pubmed: 9278850
Exp Neurol. 2014 Feb;252:12-7
pubmed: 24246282
Neurotherapeutics. 2015 Jul;12(3):667-77
pubmed: 25956401
Brain Res Brain Res Protoc. 2005 Apr;14(3):181-90
pubmed: 15795172
Curr Drug Targets. 2007 Jul;8(7):846-9
pubmed: 17630938
Front Biosci (Elite Ed). 2011 Jan 01;3:604-15
pubmed: 21196338
J Orthop. 2019 May 27;16(6):493-495
pubmed: 31680738
BMJ. 2017 Jan 10;356:i6635
pubmed: 28073753
Anesth Analg. 2017 Apr;124(4):1053-1060
pubmed: 27622718
JAMA Surg. 2015 Jan;150(1):59-64
pubmed: 25472595
Can J Anaesth. 2016 Feb;63(2):193-204
pubmed: 26391795
Med Gas Res. 2017 Mar 30;7(1):48-55
pubmed: 28480032
J Cardiothorac Vasc Anesth. 2018 Aug;32(4):1701-1708
pubmed: 29402628
Epidemiology. 2018 Sep;29(5):e45-e47
pubmed: 29912013
Br J Anaesth. 2003 Aug;91(2):170-4
pubmed: 12878613
J Clin Neurophysiol. 2016 Jun;33(3):196-202
pubmed: 27258442
N Engl J Med. 2007 Feb 15;356(7):706-13
pubmed: 17301301
J Neurosurg Anesthesiol. 2001 Jan;13(1):26-32
pubmed: 11145474
Exp Neurol. 2008 Jul;212(1):201-6
pubmed: 18501348
Sentinel Event Alert. 2004 Oct 6;(32):1-3
pubmed: 15470805
JAMA. 2018 Feb 6;319(5):452-462
pubmed: 29411032
Lancet Neurol. 2003 Dec;2(12):741-6
pubmed: 14636779
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
N Engl J Med. 2008 Mar 13;358(11):1097-108
pubmed: 18337600
Anesthesiology. 2017 Apr;126(4):653-665
pubmed: 28182585
Anesthesiology. 1998 Feb;88(2):440-51
pubmed: 9477065
Stroke. 2016 Feb;47(2):581-641
pubmed: 26696642
Stroke. 2009 Apr;40(4):1032-7
pubmed: 19211484
Exp Brain Res. 2013 Jan;224(2):155-64
pubmed: 23064810
Eur J Cardiothorac Surg. 2014 Jan;45(1):159-64
pubmed: 23671201
Eur Heart J. 2019 Mar 14;40(11):914-924
pubmed: 30020431
Stroke. 2019 Aug;50(8):2101-2107
pubmed: 31303151
Br J Anaesth. 2011 Jun;106(6):840-50
pubmed: 21518736
Ann Intern Med. 2017 Aug 15;167(4):268-274
pubmed: 28693043
Stroke. 1989 Jul;20(7):864-70
pubmed: 2749846
Brain Res Brain Res Protoc. 2002 Apr;9(2):112-21
pubmed: 12034330
J Neurosurg Anesthesiol. 2014 Oct;26(4):273-85
pubmed: 24978064
Med Gas Res. 2016 Dec 30;6(4):194-205
pubmed: 28217291
J Am Heart Assoc. 2021 Feb;10(5):e018952
pubmed: 33634705
J Cereb Blood Flow Metab. 2007 Jul;27(7):1377-86
pubmed: 17264860
Anesth Analg. 2015 Sep;121(3):645-51
pubmed: 26097989
Acta Anaesthesiol Scand. 2005 Sep;49(8):1063-7
pubmed: 16095444
J Neurointerv Surg. 2016 Nov;8(11):1101-1106
pubmed: 26614493