for cardiac surgery with cardiopulmonary bypass. We hypothesized that anesthetic preference would vary considerably among surveyed providers without a clear majority, as would the rationale behind those preferences. METHODS: Email invitations were sent to members of the Society of Cardiovascular Anesthesiologists, who were asked to identify the anesthetics or sedatives they typically prefer to administer during induction, prebypass, bypass, postbypass, and postoperative periods and why they prefer those agents. Members’ beliefs regarding the importance of anesthetics on postoperative outcomes were also assessed. RESULTS: Invitations were sent on 2 separate dates to 3328 and 3274 members, of whom 689 (21%) responded. The median (interquartile range [IQR]) respondent age was 45 (37–56) years, 79% were men, and 75% were fellowship trained. The most frequently chosen drug for induction was propofol (80%). Isoflurane was the most frequently selected primary agent for the prebypass (57%), bypass (62%), and postbypass periods (50%). Sevoflurane was the second most frequently selected (30%; 17%, and 24%, respectively). Propofol was the third most frequently selected agent for the bypass (14%) and postbypass periods (17%). Ease of use was the most frequently selected reason for administering isoflurane and sevoflurane for each period. During bypass, the second most frequently selected rationale for using isoflurane and sevoflurane was institutional practice. A total of 76% responded that the perfusionist typically delivers the bypass anesthetic. Ischemic preconditioning, organ protection, and postoperative cognitive function were infrequently selected as rationales for preferring the volatile anesthetics. Most respondents (73%) think that anesthetics have organ-protective properties, especially isoflurane (74%) and sevoflurane (59%), and 72% believed that anesthetic choice contributes to patient outcome. The median (IQR) agreement (0 = strongly disagree to 100 = strongly agree) was 72 (63–85) for the statement that “inhaled anesthetics are an optimal maintenance anesthetic for cardiac surgery.” CONCLUSIONS: In a survey of cardiac anesthesiologists, a majority of respondents indicated that they prefer volatile anesthetics for maintenance of anesthesia, that anesthetic selection impacts patient outcomes, and that volatile anesthetics have organ-protective properties. The members’ rationales for preferring these agents possibly reflect that practical considerations, such as ease of use, effectiveness, and institutional practice, also influence anesthetic selection during cardiac surgery in addition to considerations such as organ protection....

中文翻译：

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心脏麻醉的麻醉偏好：心血管麻醉医师协会的调查


用于体外循环心脏手术。我们假设，在没有明显多数的情况下，接受调查的提供者之间的麻醉偏好会有很大差异，这些偏好背后的基本原理也是如此。方法：向心血管麻醉医师协会的成员发送电子邮件邀请，要求他们确定他们在诱导、搭桥前、搭桥、搭桥后和术后期间通常喜欢使用的麻醉剂或镇静剂，以及为什么他们喜欢这些药物。还评估了成员对麻醉剂对术后结果重要性的看法。结果：在 2 个不同的日期向 3328 名和 3274 名会员发出了邀请，其中 689 名 (21%) 做出了回应。受访者年龄中位数（四分位距 [IQR]）为 45 (37-56) 岁，79% 为男性，75% 接受过专科培训。最常选择的诱导药物是异丙酚（80%）。异氟烷是搭桥前（57%）、搭桥（62%）和搭桥后（50%）最常选择的主要药物。七氟醚是第二常见的选择（分别为 30%、17% 和 24%）。异丙酚是搭桥术 (14%) 和搭桥术后 (17%) 期间第三大最常选择的药物。易于使用是每个时期施用异氟醚和七氟醚最常选择的原因。在搭桥期间，使用异氟醚和七氟醚的第二个最常选择的理由是机构实践。总共 76% 的受访者表示，灌注师通常会提供旁路麻醉。缺血预处理、器官保护和术后认知功能很少被选为首选挥发性麻醉剂的理由。 大多数受访者 (73%) 认为麻醉剂具有器官保护特性，尤其是异氟烷 (74%) 和七氟烷 (59%)，72% 的受访者认为麻醉剂的选择有助于患者的预后。对于“吸入麻醉剂是心脏手术的最佳维持麻醉剂”这一说法，同意中位数 (IQR)（0 = 强烈不同意到 100 = 强烈同意）为 72 (63–85)。结论：在对心脏麻醉医师的一项调查中，大多数受访者表示他们更喜欢使用挥发性麻醉剂来维持麻醉，麻醉剂的选择会影响患者的预后，并且挥发性麻醉剂具有器官保护特性。成员们偏爱这些药物的理由可能反映出，除了器官保护等考虑因素之外，易用性、有效性和机构实践等实际考虑因素也会影响心脏手术期间的麻醉选择……