Sevoflurane versus Isoflurane in Patients Undergoing Valvular Heart Replacements: A Comparative Study

ABSTRACT

Introduction: Sevoflurane is a volatile anesthetic agent, which is non-irritant with low solubility and lack of arrhythmogenicity, which makes it an ideal agent for ambulatory anesthesia. The aim of our study is to compare the cardiovascular effects at equivalent minimum alveolar concentration (MAC) doses and the recovery profile of sevoflurane and isoflurane, in patients undergoing valvular replacement surgery. Materials and Methods: This is a hospital-based, randomized, interventional, comparative study with sample size of seventy participants divided into two groups. Group A (35) received sevoflurane (1MAC) and Group B (35) received isoflurane (1MAC). Patients were of the American Society of Anesthesiologists Grade 2–4. The age group was 20–25 years with body weight of 30–65 kg, undergoing valvular heart surgery. The primary outcomes are to compare the changes in heart rate, systolic and diastolic blood pressures, mean arterial pressure, cardiac output (CO), cardiac index, systemic vascular resistance index (SVRI), and stroke volume variable, during maintenance of anesthesia. The secondary outcomes are the time taken for eye opening on verbal commands and extubation. Results: There was a decrease in blood pressure, CO, and SVRI with both agents (statistically insignificant, P > 0.05), but comparatively hemodynamics was more stable along with early recovery with sevoflurane (statistically insignificant). Conclusions: Sevoflurane and isoflurane can safely be used for fast-track anesthesia in patients undergoing valvular heart surgery. Sevoflurane provided a better hemodynamic profile, early awakening, and extubation as compared with isoflurane, even though the difference was insignificant. Thus, sevoflurane with opioids may be preferred in patients undergoing valvular heart surgery