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BACKGROUND	The effect of anaesthesia on postoperative outcome is unclear .
BACKGROUND	Cardioprotective properties of volatile anaesthetics have been demonstrated experimentally and in haemodynamically stable patients undergoing coronary artery bypass grafting .
BACKGROUND	Their effects in patients undergoing high-risk cardiac surgery have not been reported .
METHODS	We performed a multicentre , randomized , parallel group , controlled study among patients undergoing high-risk cardiac surgery ( combined valvular and coronary surgery ) in 2008-2011 .
METHODS	One hundred subjects assigned to the treatment group received sevoflurane for anaesthesia maintenance , while 100 subjects assigned to the control group received propofol-based total i.v. anaesthesia .
METHODS	The primary outcome was a composite of death , prolonged intensive care unit ( ICU ) stay , or both .
METHODS	Thirty day and 1 yr follow-up , focused on mortality , was performed .
RESULTS	All 200 subjects completed the follow-up and were included in efficacy analyses , conducted according to the intention-to-treat principle .
RESULTS	Death , prolonged ICU stay , or both occurred in 36 out of 100 subjects ( 36 % ) in the propofol group and in 41 out of 100 subjects ( 41 % ) in the sevoflurane group ; relative risk 1.14 , 95 % confidence interval 0.8-1 .62 ; P = 0.5 .
RESULTS	No difference was identified in postoperative cardiac troponin release [ 1.1 ( 0.7-2 ) compared with 1.2 ( 0.6-2 .4 ) ng ml ( -1 ) , P = 0.6 ] , 1 yr all-cause mortality [ 11/100 ( 11 % ) compared with 11/100 ( 11 % ) , P = 0.9 ] , re-hospitalizations [ 20/89 ( 22.5 % ) compared with 11/89 ( 12.4 % ) , P = 0.075 ] , and adverse cardiac events [ 10/89 ( 11.2 % ) compared with 9/89 ( 10.1 % ) , P = 0.8 ] .
CONCLUSIONS	There was no observed beneficial effect of sevoflurane on the composite endpoint of prolonged ICU stay , mortality , or both in patients undergoing high-risk cardiac surgery .
BACKGROUND	ClinicalTrials.gov : identifier NCT00821262 .
BACKGROUND	Eudra CT ( 2008-001752-43 ) .

