Sevoflurane- and propofol-based regimens show comparable effect on oxygenation in patients undergoing cardiac valve replacement with cardiopulmonary bypass

Cardiovasc J Afr. 2020 Mar/Apr;31(4):71-74. doi: 10.5830/CVJA-2019-050. Epub 2019 Sep 11.

Abstract

Background: Our study aimed to compare the effects of Sevoflurane- and propofol-based anaesthetic regimens on oxygenation during the early period of cardiopulmonary bypass (CPB) in patients undergoing cardiac valve-replacement surgery.

Methods: Patients undergoing mechanical mitral, aortic or double valve replacement were enrolled and randomly divided into two groups: the sevoflurane-based anaesthetic regimen group consisted of patients who received 1-3% sevoflurane inhalation during anaesthesia maintenance and the propofol-based anaesthetic regimen group consisted of patients who received 6-10 mg/kg/h of propofol infusion during anaesthesia maintenance. The partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2), respiratory mechanics and haemodynamics were recorded during CPB.

Results: Forty-two patients met the eligibility criteria for the study. The groups did not differ in terms of clinical and demographic characteristics, and pre- and intra-operative features. Changes in oxygenation were mild (mean PaO2/FiO2 from 358 ± 82 to 471 ± 106 mmHg) within one hour of CPB in our patients. There were no differences in PaO2/FiO2, respiratory mechanics and haemodynamics between the sevoflurane and propofol groups.

Conclusions: In patients undergoing cardiac valve replacement with CPB, lung injury was mild, and sevoflurane- and propofol-based anaesthetic regimens showed similar effect on oxygenation, respiratory mechanics and haemodynamics during the early stage of CPB.

Keywords: cardiac valve replacement; cardiopulmonary bypass; oxygenation; propofol; sevoflurane.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anesthetics, Inhalation / administration & dosage*
  • Anesthetics, Inhalation / adverse effects
  • Anesthetics, Intravenous / administration & dosage*
  • Anesthetics, Intravenous / adverse effects
  • Cardiopulmonary Bypass* / adverse effects
  • China
  • Female
  • Heart Valve Prosthesis Implantation* / adverse effects
  • Heart Valve Prosthesis Implantation* / instrumentation
  • Heart Valves / surgery*
  • Hemodynamics / drug effects
  • Humans
  • Lung / drug effects*
  • Lung / physiopathology
  • Lung Injury / etiology
  • Lung Injury / physiopathology
  • Male
  • Middle Aged
  • Oxygen / blood*
  • Propofol / administration & dosage*
  • Propofol / adverse effects
  • Prospective Studies
  • Respiratory Mechanics / drug effects*
  • Sevoflurane / administration & dosage*
  • Sevoflurane / adverse effects
  • Time Factors
  • Treatment Outcome

Substances

  • Anesthetics, Inhalation
  • Anesthetics, Intravenous
  • Sevoflurane
  • Oxygen
  • Propofol