Sevoflurane in Cardiac Surgery: a Haemodynamic Study

Overview

In cardiac anaesthesia, there is observed an increasing interest in new inhalational agents. One of the recently introduced agents is represented bysevoflurane, which appears to be as suitable as isoflurane for balanced anaesthesia for cardiac surgery. The goal of the study was to compare theeffect of sevoflurane (n = 20) to isoflurane (n = 11) on haemodynamics of patients operated on for valvular heart disease. The data were compared tothe group treated with vasodilator agent nitroglycerine (n = 11) instead of inhalational agent. Haemodynamic data were obtained from thermodilutioncatheter technique and transesophageal echocardiography. Based on the data from this observational study we can conclude that sevoflurane getscloser to an „ideal anaesthetic“ profile. Medium concentrations (1,2 MAC) stabilize heart rate; mild cardiac depressive effect is compensated withsurgical stimulation. While venous filling is maintained, systemic arterial pressure drops are mild, smooth and predictable. Compared to isoflurane,sevoflurane better stabilized heart rate, even after myocardial ischaemia. There were observed regional wall motion abnormalities associated withhigher concentrations of sevoflurane in this group of patients. This finding was not documented in the literature yet; further studies regarding thisphenomenon are warranted.

Key words:
inhalational anaesthetics – haemodynamics – cardiac anaesthesia – dyskinesis – valvular heart lesions