The Show Goes On

The pick of the last two months focuses on an anesthesia related article, to put it better, on a perioperative intensive care approach. The article published by Manolescu Rely et al investigates the possible myocardial protection due to sevoflurane anesthesia delivered to cardiac patients submitted to non-cardiac, that is to elective abdominal surgery [1]. They assessed cardiac patients using the Lee’s cardiac score. All the patients scored in excess of 3 points. An impressive number of markers were monitored immediately following intubation, but before actually performing the incision: cardiac biomarkers – troponin I, the precursor of the brain natriuretic peptide – proBNP, and the myocardial creatine kinase – CKMB. A panel of inflammatory markers was concomitantly followed: the high sensitive C-reactive protein CRP, the fibrinogen – FBG and interleukin 6 – IL 6. There were five times sampling points including at 24 and 48 hours post surgery for all the markers. Two groups of patients were anaesthetized either with sevoflurane or with total intravenous targeted to propofol serum concentration anesthesia, TIVA-TCI. The patients were carefully assessed preoperatively and invasively monitored during and following surgery. The variations due to different surgical or anesthesia teams were excluded since the same team was involved with all the patients. [More]