Summary:
In cardiac anaesthesia, there is observed an increasing interest in new inhalational agents. One of the recently introduced agents is represented by
sevoflurane, which appears to be as suitable as isoflurane for balanced anaesthesia for cardiac surgery. The goal of the study was to compare the
effect of sevoflurane (n = 20) to isoflurane (n = 11) on haemodynamics of patients operated on for valvular heart disease. The data were compared to
the group treated with vasodilator agent nitroglycerine (n = 11) instead of inhalational agent. Haemodynamic data were obtained from thermodilution
catheter technique and transesophageal echocardiography. Based on the data from this observational study we can conclude that sevoflurane gets
closer to an „ideal anaesthetic“ profile. Medium concentrations (1,2 MAC) stabilize heart rate; mild cardiac depressive effect is compensated with
surgical 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 with
higher concentrations of sevoflurane in this group of patients. This finding was not documented in the literature yet; further studies regarding this
phenomenon are warranted.
Key words:
inhalational anaesthetics – haemodynamics – cardiac anaesthesia – dyskinesis – valvular heart lesions
|