S R Bennett1, S C Griffin. 1. Department of Anaesthesia, Castle Hill Hospital, Hull, England. sean@Remproad.freeserve.co.uk
Abstract
OBJECTIVE: To determine if sevoflurane provides hemodynamic and recovery characteristics comparable to isoflurane in patients undergoing surgery for valvular heart disease. 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 center. PARTICIPANTS: Twenty-seven patients scheduled for elective valve surgery. Surgery consisted of 18 aortic valve and 12 mitral valve replacements, of which 3 patients had 2 valves replaced; 1, tricuspid repair; and 8, coronary artery bypass procedures. INTERVENTIONS: A pulmonary artery catheter was used to obtain a complete hemodynamic profile during the dose-response study before surgery. Transesophageal echocardiography was used to confirm the diagnosis, and electrocardiography monitored for myocardial ischemia. MEASUREMENTS AND MAIN RESULTS: Both agents showed similar hemodynamic effects at 0.5 and 1.0 minimum alveolar concentration. There was a tendency to decreases in heart rate, blood pressure, and cardiac output, whereas filling pressures remained stable with each volatile agent. Electrocardiography did not detect ischemic changes. Times to eye opening and extubation were similar with both agents, with sevoflurane tending to be earlier than isoflurane. CONCLUSION:Sevoflurane showed a tendency to lower heart rates and cardiac index compared with isoflurane. Eye opening and extubation were slightly earlier. These findings were not statistically significant, however. Copyright 2001 by W.B. Saunders Company
RCT Entities:
OBJECTIVE: To determine if sevoflurane provides hemodynamic and recovery characteristics comparable to isoflurane in patients undergoing surgery for valvular heart disease. 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 center. PARTICIPANTS: Twenty-seven patients scheduled for elective valve surgery. Surgery consisted of 18 aortic valve and 12 mitral valve replacements, of which 3 patients had 2 valves replaced; 1, tricuspid repair; and 8, coronary artery bypass procedures. INTERVENTIONS: A pulmonary artery catheter was used to obtain a complete hemodynamic profile during the dose-response study before surgery. Transesophageal echocardiography was used to confirm the diagnosis, and electrocardiography monitored for myocardial ischemia. MEASUREMENTS AND MAIN RESULTS: Both agents showed similar hemodynamic effects at 0.5 and 1.0 minimum alveolar concentration. There was a tendency to decreases in heart rate, blood pressure, and cardiac output, whereas filling pressures remained stable with each volatile agent. Electrocardiography did not detect ischemic changes. Times to eye opening and extubation were similar with both agents, with sevoflurane tending to be earlier than isoflurane. CONCLUSION:Sevoflurane showed a tendency to lower heart rates and cardiac index compared with isoflurane. Eye opening and extubation were slightly earlier. These findings were not statistically significant, however. Copyright 2001 by W.B. Saunders Company
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