Propofol versus isoflurane anesthesia: Comparsion of hemodynamic parameters in cardiac surgeries.

ABSTRACT

Aim: The hemodynamic effects of propofol-fentanyl and isoflurane-fentanyl anesthesia during surgery were compared in 100 patients undergoing coronary artery bypass grafting (CABG) and valvular surgeries. Material and Methods: Patients were divided into two groups randomly. Group PF (n=50) were induced with Fentanyl, Midazolam, Vecuronium and Propofol infusion. While Group IF (n=50) were induced with Fentanyl, Midazolam, Vecuronium and Isoflurane (0-2%) as per the standard doses. Hemodynamic measurements were made before induction of anesthesia and at various times throughout the surgery. Observation and Results: Significant decreases in mean arterial pressure MAP, left ventricular stroke work index (LVSWI), and stroke volume index (SVI) occurred after 15 minutes of propofol anesthesia. With isoflurane MAP was well maintained with reductions in LVSWI and SVI. Isoflurane was, however, associated with a slight increase in heart rate (HR), whereas no significant change in HR in patients receiving propofol. With both techniques there was no significant change in systemic vascular resistance index. Isoflurane prevents myocardial damage and thus it is cardio protective by developing ischemic preconditioning phenomenon. Conclusion: The study suggests that propofol-fentanyl anesthesia is an acceptable technique but Isoflurane- fentanyl is still preferred due to less hemodynamic instability and greater myocardial protection in cardiac surgeries.