Sevoflurane versus isoflurane in patients undergoing coronary artery bypass grafting: A hemodynamic and recovery study

Objective: To determine if sevoflurane provides comparable hemodynamics and recovery characteristics to isoflurane in cardiac anesthesia. Design:A 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. Setting: Tertiary referral cardiac clinic and intensive care. Participants: Sixteen elective patients scheduled for coronary artery bypass grafting. Interventions: A pulmonary artery catheter was used to obtain a complete hemodynamic profile during the dose-response study before surgery. Transesophageal echocardiography (TEE) and an electrocardiogram (EGG) were used to assess myocardial ischemia. Measurements and Main Results: Both 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 EGG. Times to eye opening and extubation were similar for both agents. Conclusion: At 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. Copyright (C) 1999 by W.B. Saunders Company.