Original Article

Comparison of Myocardial Protective Effect of Desflurane Anesthesia Versus Sevoflurane Anesthesia During CABG Surgery

10.5222/otd.2012.094

  • Asime Ay
  • Belkıs Tanrıverdi

Received Date: 20.06.2011 Accepted Date: 06.01.2012 Eur Arc Med Res 2012;28(2):94-102

Objective:

Since the first years of open heart surgery it has been noticed that morbidity, mortality are mostly associated with postoperative cardiac pump insuffiency. The reason of postoperative cardiac pump insufficiency after CABG surgery is myocardial injury seen after the ischemic cardiac arrest and reperfusion.The aim of this study is to compare the myocardial protective effect of desflurane anesthesia versus sevoflurane anesthesia for the patients undergoing CABG surgery.

Methods:

The study was performed on 40 patients, ASA II-IV status, aged between 18-65 years, undergoing elective CABG surgery. The patients were randomly divided into two groups, each having 20 patients. On the operation table, SBP, DBP, MAP, HR, SpO2, CVP monitorizations were recorded. For induction 0.3 mg/kg etomidate I.V. was administered. After the loss of eye lash reflex and ventilation, 0.1 mg/kg pancuronium IV, and 1 μ/kg remifentanil I.V. were administered to all patients. In Group D; 1-4 % Desflurane and for Group S patients 2-4 % sevoflurane were started. For all patients, 0.1-0.4 μ/kg/min remifentanil infusion was started. At the end of the surgery all anesthetic agents were stopped and patients were transfered to intensive care unit, then connected to mechanical ventilator with SIMV mode and hemodynamical data were recorded.

Results:

There were no differences in demographic data of both groups. In both groups, troponin I, CK and CKMB levels were increased at postoperative 6. and 24. hours. But the increase in sevoflurane group was less relative to desflurane group at postoperative 24. hours.

Conclusion:

We have concluded that desflurane and sevoflurane provided sufficient anesthesia level and hemodynamic stability, and decreased perioperative myocardial injury. It has been thought that sevoflurane provided better myocardial protection than desflurane, depending on the levels of myocardial injury markers, troponin I, CK, and CK-MB.

Keywords: CABG, desflurane, sevoflurane, myocardial protection, myocardial injury