Any rationale for propofol use in cardiac surgery?

摘要

We read with interest the article by Krzych et al1 regarding propofol use in cardiac surgery. We agree with the authors that propofol is widely used in cardiac surgery worldwide for the induction and maintenance of general anesthesia and for sedation in intensive care units. We disagree that there is any evidence-based rationale to support its use in cardiac surgery when patients' clinically relevant outcomes are considered.A recent meta-analysis of 22 randomized controlled trials published in this journal2 suggested that patients receiving total intravenous anesthesia (propofol in 19 of 22 studies) have an increased mortality (14/872 [1.6%] v 4/977 [0.4%], odds ratio = 0.31 [0.12-0.80], p = 0.02) and an increased incidence of myocardial infarction (45/874 [5.1%] v 24/979 [2.4%], odds ratio = 0.51 [0.32-0.84], p = 0.008) when compared with patients receiving volatile agents.