Sevoflurane versus isoflurane in patients undergoing coronary artery bypass grafting: A hemodynamic and recovery study

• Published in: Journal of cardiothoracic and vascular anesthesia Vol. 13; no. 6; pp. 666 - 672
• Main Authors: Bennett, Sean R., Griffin, Steve C.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01.12.1999; Elsevier
• Subjects: Aged; Anesthesia; Anesthesia depending on type of surgery; Anesthesia Recovery Period; Anesthesia, Inhalation; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Pressure - drug effects; Cardiac Output - drug effects; cardiac surgery; Coronary Artery Bypass - methods; Cross-Over Studies; Dose-Response Relationship, Drug; Echocardiography, Transesophageal; Electrocardiography; Female; Heart Rate - drug effects; Hemodynamics - drug effects; Humans; inhalation anesthetics; Isoflurane - pharmacology; Male; Medical sciences; Methyl Ethers - pharmacology; Middle Aged; Prospective Studies; Sevoflurane; Thoracic and cardiovascular surgery. Cardiopulmonary bypass; transesophageal echocardiography; Vascular Resistance - drug effects; inhalation anesthetics; cardiac surgery; transesophageal echocardiography; Volatile compound; Human; Cardiovascular disease; General anesthesia; Coronary heart disease; Myocardial disease; Isoflurane; Vascular disease; Sevoflurane; General anesthetic; Aortocoronary; Ischemia; Bypass; Surgery; Myocardium; Complication; Hemodynamics; Comparative study; Halogen Organic compounds
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1016/S1053-0770(99)90117-9

Objective: To determine if sevoflurane provides comparable hemodynamics and recovery characteristics to isoflurane in cardiac anesthesia. Design: A prospective, crossover, dose-response study using sevoflurane and isoflurane before the start of surgery, followed by randomization to sevoflurane or isoflurane for surgery with blinded assessment for recovery. Setting: Tertiary referral cardiac clinic and intensive care. Participants: Sixteen elective patients scheduled for coronary artery bypass grafting. Interventions: A pulmonary artery catheter was used to obtain a complete hemodynamic profile during the dose-response study before surgery. Transesophageal echocardiography (TEE) and an electrocardiogram (ECG) were used to assess myocardial ischemia. Measurements and Main Results: Both agents showed similar hemodynamic effects at 0.5 and 1.0 minimum alveolar concentration (MAC). There was a tendency toward decreases in heart rate, blood pressure, vascular resistance, and cardiac output with a rise in central pressures. Ischemic changes were not detected by TEE or ECG. Times to eye opening and extubation were similar for both agents. Conclusion: At MAC equivalent doses, sevoflurane showed comparable hemodynamics to isoflurane. Both agents when used as the primary anesthetic showed similar recovery characteristics, with no statistical difference between them at any stage of the study.