J Korean Med Sci.
2018 Jan;33(4):e28. 10.3346/jkms.2018.33.e28.
Isoflurane's Effect on Intraoperative Systolic Left Ventricular Performance in Cardiac Valve Surgery Patients
- Affiliations
-
- 1Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, Busan, Korea.
- 2Department of Anesthesiology, Konkuk University Medical Center, Seoul, Korea. taeyop@gmail.com
- 3Department of Anesthesiology, Konkuk University School of Medicine, Seoul, Korea.
- 4Department of Anesthesiology, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
- 5Cardiothoracic Anaesthesiology and Perfusion Unit, Sarawak General Hospital, Jalan Tun Ahmad Zaidi Adruce, Sarawak, Malaysia.
- 6Department of Anesthesiology, Chung-Ang University School of Medicine, Seoul, Korea.
- 7Department of Anesthesiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
- 8Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Seoul, Korea.
- KMID: 2400646
- DOI: http://doi.org/10.3346/jkms.2018.33.e28
Abstract
- BACKGROUND
Isoflurane, a common anesthetic for cardiac surgery, reduced myocardial contractility in many experimental studies, few studies have determined isoflurane's direct impact on the left ventricular (LV) contractile function during cardiac surgery. We determined whether isoflurane dose-dependently reduces the peak systolic velocity of the lateral mitral annulus in tissue Doppler imaging (S"²) in patients undergoing cardiac surgery.
METHODS
During isoflurane-supplemented remifentanil-based anesthesia for patients undergoing cardiac surgery with preoperative LV ejection fraction greater than 50% (n = 20), we analyzed the changes of S"² at each isoflurane dose increment (1.0, 1.5, and 2.0 minimum alveolar concentration [MAC]: T1, T2, and T3, respectively) with a fixed remifentanil dosage (1.0 μg/min/kg) by using transesophageal echocardiography.
RESULTS
Mean S"² values (95% confidence interval [CI]) at T1, T2, and T3 were 10.5 (8.8-12.2), 9.5 (8.3-10.8), and 8.4 (7.3-9.5) cm/s, respectively (P < 0.001 in multivariate analysis of variance test). Their mean differences at T1 vs. T2, T2 vs. T3, and T1 vs. T3 were −1.0 (−1.6, −0.3), −1.1 (−1.7, −0.6), and −2.1 (−3.1, −1.1) cm/s, respectively. Phenylephrine infusion rates were significantly increased (0.26, 0.22, and 0.47 μg/kg/min at T1, T2, and T3, respectively, P < 0.001).
CONCLUSION
Isoflurane increments (1.0-2.0 MAC) dose-dependently reduced LV systolic long-axis performance during cardiac surgeries with a preserved preoperative systolic function.
Keyword
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Comparison of Postoperative LV Function after Mitral Valve Replacement and Predictor of Postoperative LV Function in Chronic Mitral Regurgitation
- A Case of Left Ventricular Outflow Obstruction Caused by Mitral Valve Replacement
- Left Ventricular Outflow Tract Obstruction Caused by Accessory Mitral Valve Tissue in a Child: A case report
- Relation of hemodynamic load to left ventricular hypertrophy and performance in essential hypertension
- Comparison of Left and Right Ventricular Volume and Cardiac Output by MRI and Echocardiography
