2025 FSA Podium and Poster Abstracts

Introduction/Background: Xenon gas has gained attention as a potential alternative to conventional volatile anesthetics due to its unique pharmacologic properties. It is an inert noble gas with minimal metabolism, reducing the risk of organ toxicity. Xenon also provides neuroprotection, hemodynamic stability, and rapid emergence from anesthesia. Additionally, its lack of environmental pollution makes it an attractive option compared to traditional volatile agents. However, its high cost and limited availability have hindered widespread adoption. This review evaluates the efficacy, benefits, and challenges associated with xenon anesthesia and its potential role in future anesthetic practice.

Methods: To comprehensively examine the role of xenon in anesthetic care, an exhaustive systematic literature search was conducted utilizing the databases of PubMed, Embase, and Cochrane Library. The following keywords were utilized in combination for data extraction purposes: (Xenon AND anesthesia) OR (Xenon AND neuroprotection) OR (Xenon AND hemodynamic stability) OR (Xenon AND recovery) OR (Xenon AND cost-effectiveness). Inclusion criteria included articles published within the last 20 years, patients aged 19+, and articles that were randomized controlled trials, meta-analyses, and systematic reviews. Primary outcomes of postoperative cognitive function, hemodynamic stability, and anesthetic recovery time were examined. Secondary outcomes such as environmental impact, cost-effectiveness, and clinical feasibility were also examined.

Results: Multiple studies have highlighted the potential of xenon as an ideal anesthetic agent, focusing on its hemodynamic stability, cardioprotective effects, and neuroprotective properties. In cardiac surgery, xenon combined with propofol significantly reduced intraoperative norepinephrine requirements, had fewer postoperative complications, and maintained mean arterial pressure better than propofol alone. Xenon anesthesia was shown to limit myocardial damage during on-pump coronary artery bypass grafting surgery, as evidenced by lower postoperative cardiac troponin I levels compared to both sevoflurane and total intravenous anesthesia. Additionally, xenon demonstrated enhanced left ventricular recovery in comatose survivors of out-of-hospital cardiac arrest and offered moderate protection against myocardial ischemia-reperfusion injury. In renal surgeries, xenon outperformed isoflurane in maintaining hemodynamic stability and reducing the need for vasopressors]. Xenon’s rapid induction and emergence properties suggest it may reduce postoperative cognitive dysfunction in elderly patients, although large-scale clinical validation remains necessary. The high cost associated with xenon anesthesia remains a significant limitation, with delivery systems and recycling technologies offering promising solutions.

Discussion/Conclusion: Xenon anesthesia presents a compelling case as an ideal anesthetic agent due to its unique pharmacologic profile, offering neuroprotection, cardiovascular stability, and rapid recovery. Its potential to reduce myocardial injury, enhance postoperative cardiac function, and mitigate postoperative cognitive dysfunction makes it attractive for high-risk patient populations. The economic burden of xenon, stemming from its rarity and high costs of extraction, delivery, and recycling, has limited its routine clinical application. Strategies such as pre-anesthetic denitrogenation, efficient closed-circuit systems, and advancements in xenon reclamation technology are critical to making xenon more accessible. Xenon may be beneficial in prolonged surgical or critical care settings, where its rapid emergence and organ-protective properties could outweigh its higher cost. Future research should aim to optimize xenon delivery systems, explore combination therapies, and validate its long-term benefits.