• C L Christiansen, P Ahlburg, C J Jakobsen, E B Andresen, and P K Paulsen.
• Department of Anaesthesia, Skejby Hospital, Aarhus, Denmark.
• J. Cardiothorac. Vasc. Anesth. 1998 Aug 1;12(4):418-21.

ObjectiveBecause propofol is known to reduce vascular resistance, the objective of this study was to compare the indices of hepatosplanchnic circulation and oxygenation during cardiopulmonary bypass (CPB) in patients anesthetized with either propofol or midazolam/halothane.DesignA prospective, randomized, nonblinded study.SettingA university hospital.ParticipantsTwenty patients undergoing cardiac surgery with CPB.InterventionsNine patients were anesthetized with propofol/fentanyl/pancuronium and 11 patients were anesthetized with midazolam/halothane/fentanyl/pancuronium. All patients had a nasogastric tonometer tube and two fiberoptic thermodilution catheters inserted; one in the pulmonary artery and one in the upper right hepatic vein. During bypass, SvO2s were measured from the venous line of the heart-lung machine.Measurements And Main ResultsGastric mucosal pH (pHi) was measured prebypass, 30 minutes after the start of CPB, and just before weaning off CPB. Hepatic SvO2 (HSvO2) values were recorded every 5 minutes. The pH gap was less at 30 minutes of hypothermic CPB in the propofol group. In the midazolam/halothane group, the HSvO2 decreased after the start of rewarming, whereas in the propofol group the values remained almost at the prebypass levels. At the end of rewarming, the HSvO2 was almost identical in the two groups.ConclusionPropofol preserved the HSvO2 during CPB and produced a more optimal relationship between the hepatosplanchnic blood flow and oxygen consumption.

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