David Wild
Clinical Anesthesiology - ISSUE: OCTOBER 2012 | VOLUME: 38:10
Lighter anesthesia does not reduce the incidence of postoperative morbidity and short-term mortality in patients undergoing noncardiac surgery, researchers have found.
The randomized controlled study, which undercuts previous reports, also failed to reveal higher inflammatory levels among more deeply anesthetized patients. The researchers were scheduled to present their results at the 2012 annual meeting of the American Society of Anesthesiologists (abstract 1200).
“While previous work suggests that maintaining a lighter plane of anesthesia provides short-term benefits such as faster recovery, better hemodynamic control and reduced respiratory complications, nausea and vomiting and duration of hospitalization, it does not appear to prevent major morbidity,” said lead investigator Basem Abdelmalak, MD, associate professor in the Department of General Anesthesiology and Outcomes Research at the Cleveland Clinic, in Ohio.
The results are part of the DeLiT (Design and Organization of the Dexamethasone, Light Anesthesia and Tight Glucose Control) trial, a randomized, single-center analysis of the effects that dexamethasone, glucose control and, in this case, depth of anesthesia have on perioperative inflammation and complications in surgery patients.
In examining the effects of anesthesia depth, Dr. Abdelmalak and his colleagues compared a composite of more than one dozen serious outcomes—including myocardial infarction, stroke, sepsis and 30-day mortality—in 194 patients given light anesthesia and 187 given deeper anesthesia. Anesthetic depth was evaluated by bispectral index monitoring (BIS, Covidien). Dr. Abdelmalak and his team also compared plasma concentrations of the inflammatory marker high-sensitivity C-reactive protein (hsCRP).
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