• S R Bennett and S C Griffin.
• Department of Anaesthesia, Castle Hill Hospital, Hull, England.
• J. Cardiothorac. Vasc. Anesth. 1999 Dec 1;13(6):666-72.

ObjectiveTo determine if sevoflurane provides comparable hemodynamics and recovery characteristics to isoflurane in cardiac anesthesia.DesignA prospective, crossover, dose-response study using sevoflurane and isoflurane before the start of surgery, followed by randomization to sevoflurane or isoflurane for surgery with blinded assessment for recovery.SettingTertiary referral cardiac clinic and intensive care.ParticipantsSixteen elective patients scheduled for coronary artery bypass grafting.InterventionsA pulmonary artery catheter was used to obtain a complete hemodynamic profile during the dose response study before surgery. Transesophageal echocardiography (TEE) and an electrocardiogram (ECG) were used to assess myocardial ischemia.Measurements And Main ResultsBoth agents showed similar hemodynamic effects at 0.5 and 1.0 minimum alveolar concentration (MAC). There was a tendency toward decreases in heart rate, blood pressure, vascular resistance, and cardiac output with a rise in central pressures. Ischemic changes were not detected by TEE or ECG. Times to eye opening and extubation were similar for both agents.ConclusionAt MAC equivalent doses, sevoflurane showed comparable hemodynamics to isoflurane. Both agents when used as the primary anesthetic showed similar recovery characteristics, with no statistical difference between them at any stage of the study.

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