Anesthesia for Cardiac Surgery

Abstract

To the Editor: Landoni et al. (March 28 issue)¹ conclude that, among patients undergoing elective coronary-artery bypass grafting (CABG), anesthesia with a volatile (inhaled) agent did not result in significantly fewer deaths at 1 year than total intravenous anesthesia. They powered their trial by hypothesizing that 1-year all-cause mortality would be 3% with total intravenous anesthesia and 2% with volatile anesthetic agents. We believe that the hypothesis of a between-group difference of this magnitude is inconsistent with wide clinical experience and with the results of previous studies on the topic.^2-5 The trial was terminated for futility after an interim analysis, . . .