Total Intravenous Anesthesia Versus Sevoflurane-Based Inhalation Anesthesia Within an Enhanced Recovery…

Cohort studyJournal of cardiothoracic and vascular anesthesia· Jun 2026

Total Intravenous Anesthesia Versus Sevoflurane-Based Inhalation Anesthesia Within an Enhanced Recovery After Cardiac Surgery (ERACS) Protocol.

Adam Fazekas, Anna Flo Forner, Anita Brondani … Waseem Zakhary

Pain MedicineCohort studyQ2IF 1.6

Total intravenous anesthesia associated with greater postoperative hemodynamic stability than sevoflurane after cardiac surgery

Total Intravenous Anesthesia Versus Sevoflurane-Based Inhalation Anesthesia Within an Enhanced Recovery After Cardiac Surgery (ERACS) Protocol.

Adam Fazekas … Waseem Zakhary

Journal of cardiothoracic and vascular anesthesia · Jun 2026 · Q2 in Anesthesiology

Purpose

This study compared total intravenous anesthesia (total intravenous anesthesia) with sevoflurane-based inhalation anesthesia regarding perioperative outcomes in patients undergoing cardiac surgery within an Enhanced Recovery After Cardiac Surgery (Enhanced Recovery After Cardiac Surgery) protocol.

Methods

University-affiliated heart center.

n = 1,816 patients

Results

Total intravenous anesthesia patients had more stable blood pressure and heart rate after surgery

83.2%

TIVA

68.5%

Sevoflurane

More results

Sevoflurane anesthesia was associated with a slightly shorter hospital length of stay (median 10 [8-13] v 10 [8-14] days; p = 0.015) and lower postoperative pain scores (median 2 [1-2] v 2 [1-3]; p < 0.001).

In-hospital mortality was numerically higher in the total intravenous anesthesia group (15 (1.7%) v 8 (0.9%); p = 0.142).

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Conclusion · 1 of 2

Within a standardized Enhanced Recovery After Cardiac Surgery protocol, total intravenous anesthesia and sevoflurane-based anesthesia were associated with broadly similar short-term outcomes.

Conclusion · 2 of 2

Although no statistically significant difference in mortality was observed, clinically relevant differences in infrequent outcomes cannot be excluded.

Total Intravenous Anesthesia Versus Sevoflurane-Based Inhalation Anesthesia Within an Enhanced Recovery After Cardiac Surgery (ERACS) Protocol.

Total Intravenous Anesthesia Versus Sevoflurane-Based Inhalation Anesthesia Within an Enhanced Recovery After Cardiac Surgery (ERACS) Protocol.

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