Sr. Bennett et Sc. Griffin, Sevoflurane versus isoflurane in patients undergoing coronary artery bypass grafting: A hemodynamic and recovery study, J CARDIOTHO, 13(6), 1999, pp. 666-672
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 sevofl
urane 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 he
modynamic profile during the dose-response study before surgery. Transesoph
ageal echocardiography (TEE) and an electrocardiogram (EGG) were used to as
sess myocardial ischemia.
Measurements and Main Results: Both agents showed similar hemodynamic effec
ts at 0.5 and 1.0 minimum alveolar concentration (MAC). There was a tendenc
y 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 EGG. Times to eye opening and extubation were similar fo
r both agents.
Conclusion: At MAC equivalent doses, sevoflurane showed comparable hemodyna
mics to isoflurane. Both agents when used as the primary anesthetic showed
similar recovery characteristics, with no statistical difference between th
em at any stage of the study. Copyright (C) 1999 by W.B. Saunders Company.