Korean J Anesthesiol.  2004 Jan;46(1):65-71. 10.4097/kjae.2004.46.1.65.

The Hemodynamic Effects of Sevoflurane Anesthesia During Induction and Early Maintenance for Coronary Artery Bypass Graft Surgery: Compared with Fentanyl-Midazolam/Isoflurane Anesthesia

• Hwang SH
• Lim DG
• Kim SO
• Baek WY

• KMID: 2237262
• DOI: http://doi.org/10.4097/kjae.2004.46.1.65

Abstract

BACKGROUND
Sevoflurane is the most recently available volatile agent which permits the rapid induction with its nonirritant nature. The goal of this study was to compare the hemodynamic responses of sevoflurane induction and maintenance period with those of fentanyl-midazolam/isoflurane anesthesia for CABG.
METHODS
Twenty-eight patients who underwent CABG were given anesthesia, and were randomly assigned to receive sevoflurane (Sevo Group, n = 15) or fentanyl-midazolam/isoflurane (Iso-Fent Group, n = 13), as induction and maintenance agents. In the Sevo group, anesthesia was induced with two or three deep breaths of 7.5% sevoflurane, and maintained with 2% sevoflurane after intubation. The Iso-Fent Group received fentanyl 5microgram/kg and midazolam 0.2 mg/kg with oxygen for induction and maintained with 0.8% isoflurane and 5microgram/kg/hr of fentanyl by infusion. All were given vecuronium as a muscle relaxant. Cardiac and oxygen metabolic profiles were measured before and 10 minutes after tracheal intubation.
RESULTS
Before induction, there was no difference between Sevo and Iso-Fent group in terms of cardiac and oxygen metabolic profiles. After intubation, mean arterial pressure, mean pulmonary arterial pressure, pulmonary capillary wedge pressure, heart rate and mixed venous oxygen saturation in the Sevo group were higher than in the Iso-Fent group (P < 0.05). The ST-segment changes in the EKG monitoring was unremarkable during anesthesia induction in either group.
CONCLUSIONS
For the induction and early anesthesia maintenance in patients undergoing CABG surgery, sevoflurane may be a substitute for fentanyl-midazolam/isoflurane without any significant hemodynamic changes.

Keyword

CABG; fentanyl; hemodynamic change; midazolam; isoflurane; sevoflurane

MeSH Terms

Anesthesia*
Arterial Pressure
Coronary Artery Bypass*
Coronary Vessels*
Electrocardiography
Fentanyl
Heart Rate
Hemodynamics*
Humans
Intubation
Isoflurane
Metabolome
Midazolam
Oxygen
Pulmonary Wedge Pressure
Vecuronium Bromide
Fentanyl
Isoflurane
Midazolam
Oxygen
Vecuronium Bromide