ABSTRACT
Anesthetic preconditioning may contribute to the cardio protective effects of sevofiurane in patients having coronary artery bypass surgery. We investigated effects of on- pump exposure to sevofiurane for 10 minutes prior to aortic cross clamping on the hemodynamics, intraoperative ischemia and postoperative biochemical markers for patients undergoing coronary artery bypass. In this pilot study, 40 patients were randomly allocated into 2 groups. Patients of sevofiurane group received sevoflurane4vol.% corresponding to 2 minimum alveolar concentrations for exactly 10 minutes through a vaporizer on the heart-lung machine prior to aortic cross clamping; whereas patients of control group had no further intervention. Myocardial Biomarkers [CK, CK-MB and Troponin I] were measured as markers of cardiac cellular damage. Secondary outcome variables were invasive [systolic blood pressure, diastolic blood pressure, mean arterial pressure, and central venous pressure] and non-mvasive measurements [heart rate], S-T segment changes, diastolic and systolic dysfunctions and wail motion abnormalities in mid-papillary short axis view as well as the four chamber view were assessed by TEE denoting ischemia and finally the need for inotropic support. Hemodynamic parameters showed significant post bypass stability in sevofiurane group [P Value <0.05] compared to the control group, however there were no statistical significant differences between the two groups regarding intraoprative ischemia and inotropic support The myocardial biomarkers 9 hours after discharge to the ICU were comparable between the two groups. Current data demonstrates that sevoflurane-induced preconditioning maintainedhemodynamic stability in the post bypass period; however the preconditioning was without significant effects on intraoperative ischemia or postoperative myocardial biomarkers