Desflurane vs. Propofol for Cardiac Anesthesia

"After routine induction, maintain anesthesia with inhaled desflurane , adjusting concentration as needed to sustain 0.5-2 MAC . To maximize the cardioprotective effects of inhaled anesthetics, adhere to this intraoperative strategy:~Maintain ≥1 MAC continuous desflurane for ≥30 minutes ; For on-pump CABG , discontinue desflurane 15 minutes before initiating cardiopulmonary bypass (CPB) ;~If intraoperative desflurane cessation is required, implement a wash-in/wash-out strategy (recommended but non-mandatory):~Perform 3 alternating cycles of:~Wash-in : ≥10 minutes of desflurane at ≥0.5 MAC, Wash-out : ≥10 minutes of complete cessation of inhaled anesthetics. Propofol is strictly prohibited for anesthesia maintenance throughout the procedure , except during CPB."

Administer total intravenous anesthesia (TIVA) using propofol infusion at 3-8 mg/kg/h . No inhaled anesthetics are permitted for maintenance. This may be delivered via:target-controlled infusion (TCI) systems, or manual adjustment of intravenous infusion rates.