General Anesthesia in Cardiac Surgery: A Narrative Review for Evolving Techniques and Patient-Centered Best Practices

This study explores advancements in general anesthesia techniques for cardiac surgery, focusing on their impact on patient safety, surgical outcomes, and alignment with modern patient-centered care. A narrative review synthesizing recent literature and clinical guidelines was conducted, highlighting innovations in anesthetic agents, monitoring technologies, and perioperative strategies.
Methods: Sources included clinical studies, systematic reviews, and expert consensus reports relevant to adult cardiac surgery. The review emphasized induction and maintenance techniques, perioperative concerns, and the effects of anesthesia on patient outcomes, with attention to high-risk groups.
Results: Induction agents such as propofol and etomidate are tailored to cardiovascular status, while maintenance with inhalational agents (isoflurane, sevoflurane) or TIVA demonstrates myocardial protection and reduced complications. Advanced monitoring tools like transesophageal echocardiography and cerebral oximetry enhance hemodynamic management. Perioperative innovations, including multimodal analgesia and fast-track protocols, support enhanced recovery. TIVA reduces postoperative cognitive dysfunction, particularly in elderly patients, and volatile agents provide myocardial protection.
Conclusion: Advancements in anesthetic pharmacology, monitoring, and perioperative strategies improve cardiac surgery outcomes by minimizing complications, optimizing recovery, and enhancing patient safety. Further research is warranted to refine these approaches for broader implementation in diverse patient populations.