A Comparative Study of Pharmacological Myocardial Protection Between Sevoflurane and Desflurane at Anaesthestic Doses in Patients Undergoing off Pump Coronary Artery Bypass Grafting Surgery

Overview

Journal Indian J Anaesth

Specialty Anesthesiology

Date 2015 May 29

PMID 26019352

Citations 2

Authors

Umesh Sivanna

Shreedhar Joshi

Balaji Babu

A M Jagadeesh

Affiliations

Soon will be listed here.

Abstract

Background And Aims: Perioperative myocardial ischaemia (PMI) is one of the known complications during off pump coronary artery bypass (OPCAB) surgeries. The length of hospital stay is considerably prolonged in patients with PMI. Myocardial protection is an area which is being widely researched currently to prevent or reduce the incidence of PMI. Over the last decade it has become clear that volatile anaesthetic agents are protective in the setting of PMI and reperfusion. Hence, we planned to study the effect of two different volatile anaesthetics as myocardial protective agents in OPCAB surgery.

Methods: A total of 40 patients were enrolled for the study; Group A (sevoflurane, n = 20) and Group B (desflurane, n = 20). All patients had a baseline measurement of Trop-T, creatine phosphokinase-MB (CPKMB) and myocardial performance index (MPI) pre-operatively, which was repeated 4 h after the surgery. Chi-square/Fisher test was used to find the significance of the differences between the two agents.

Results: Patients were comparable in demographic, baseline, biochemical and echo criteria. Post-operative CPKMB levels (desflurane - 30.85 ± 2.69 u/L; sevoflurane - 29.05 ± 5.26 u/L, P = 0.7) and number of Trop-T positive patients (Sevoflurane - 9; desflurane - 6, P ≥ 0.05) were comparable. Post-operative MPI indicated decreased left ventricular function in sevoflurane group as compared to desflurane group (P ≤ 0.03).

Conclusion: Desflurane exerts better cardioprotective effect than sevoflurane as indicated by better MPI in OPCAB surgeries.

Citing Articles

Comparative effect of desflurane and sevoflurane on liver function tests of patients with impaired hepatic function undergoing cholecystectomy: A randomized clinical study.

Soliman R, Yacoub A, Abdellatif M Indian J Anaesth. 2020; 64(5):383-390.

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Ozcan A, Doger C, Ozturk L, Yungul A, Kurtsahin M, Neselioglu S Eurasian J Med. 2019; 51(1):70-74.

PMID: 30911261 PMC: 6422618. DOI: 10.5152/eurasianjmed.2019.18299.

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