S R Bennett1, S C Griffin. 1. Department of Anaesthesia, Castle Hill Hospital, Hull, England.
Abstract
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 forcoronary 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.
RCT Entities:
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.
Authors: Andres Zorrilla-Vaca; Rafael A Núñez-Patiño; Valentina Torres; Yudy Salazar-Gomez Journal: Biomed Res Int Date: 2017-08-29 Impact factor: 3.411
Authors: Philip M Jones; Daniel Bainbridge; Michael W A Chu; Philip S Fernandes; Stephanie A Fox; Ivan Iglesias; Bob Kiaii; Ronit Lavi; John M Murkin Journal: Can J Anaesth Date: 2016-07-27 Impact factor: 6.713