Inhaled volatile anesthetics in the intensive care unit

Table 3 Summary of short-term postoperative volatile anesthetic studies

Ref.	Treatment	Surgeries	Sedation duration	Time to awakening/extubation	Other outcomes
Non-cardiac surgery
Bellgardt et al[3], 2019, Randomized trial	Isoflurane with MIRUS™ (n = 10)	Major surgery (aortic, pancreatic, esophagectomy, spinal fusion, hyperthermic intraperitoneal chemotherapy, necrotizing fasciitis)	17.9 (16.6–20.6) h	NR	Isoflurane had longest awakening times followed by sevoflurane, with desflurane the shortest (open eyes, follow verbal commands, extubation, tell birthday). Desflurane was most expensive followed by sevoflurane, with isoflurane the cheapest (per hour)
	Sevoflurane with MIRUS™ (n = 10)		16.5 (10.4–37.4) h	NR
	Desflurane with MIRUS™ (n = 10)		18.8 (14.1–33.8) h	NR
Jung et al[27], 2020, Prospective interventional	Sevoflurane with AnaConDa (n = 25)	Head and neck surgery with tracheostomy	771 ± 338.4 min	NR	Sevoflurane required less continuous opioid. Similar vasopressor use and length of stay
	Propofol (n = 24)		1508 ± 2074.7 min	NR
Romagnoli et al[28], 2017, Prospective interventional	Sevoflurane with MIRUS™ (n = 62)	Laparoscopic and robotic-assisted noncardiac	3.33 (2.33–5.75) h	4 (2.2–5) min (awakening after drug cessation)	No adverse effects. Pollution < 1 ppm at all timepoints assessed
Cardiac surgery
Hellström et al[29], 2011, Randomized trial	Sevoflurane with AnaConDa (n = 50)	Elective or subacute coronary artery bypass grafting using cardiopulmonary bypass	176 min	NR	Sevoflurane had less intense increase in troponin at 12 h. Similar hemodynamics and length of stay
	Propofol (n = 50)		221 min	NR
Jerath et al[30], 2015, Randomized trial	Isoflurane or sevoflurane with AnaConDa (n = 67)	Elective coronary artery bypass grafting using cardiopulmonary bypass	NR	182 (140–255) min (extubation after ICU arrival)	No adverse effects. Similar hemodynamics and lengths of stay
	Propofol (n = 74)		NR	292 (210–420) min (extubation after ICU arrival)
Röhm et al[31], 2008, Randomized trial	Sevoflurane with AnaConDa (n = 35)	Elective coronary artery bypass grafting using cardiopulmonary bypass	8.1 ± 3.5 h	9.0 ± 4.0 h (extubation after ICU arrival)	Sevoflurane had faster times of recovery after sedation cessation (eye opening, following commands, hand grip, and extubation). Similar ICU length of stay, sevoflurane with lower hospital length of stay
	Propofol (n = 35)		8.4 ± 4.2 h	12.5 ± 5.8 h (extubation after ICU arrival)
Soro et al[32], 2012, Randomized trial	Sevoflurane with AnaConDa (n = 36)	Elective coronary artery bypass grafting using cardiopulmonary bypass	NR	NR	No differences in postoperative cardiac biomarkers, hemodynamics, or lengths of stay
	Propofol (n = 37)		NR	NR
Steurer et al[33], 2012, Randomized trial	Sevoflurane with AnaConDa (n = 46)	Valve replacement with cardiopulmonary bypass	At least 4 h	NR	Sevoflurane had lower troponin T and creatine kinase concentrations on postoperative day 1
	Propofol (n = 56)		At least 4 h	NR
Wąsowicz et al[34], 2018, Randomized trial	Isoflurane (n = 30) or sevoflurane (n = 30) with AnaConDa	Elective or urgent coronary artery bypass grafting using cardiopulmonary bypass	NR	172.1 ± 175.5 min (extubation after ICU arrival)	No difference in postoperative troponin values or ICU or hospital length of stay
	Propofol (n = 67)		NR	219.6 ± 104.9 min (extubation after ICU arrival)

NR: Not reported; ICU: Intensive care unit.