Effect of sevoflurane-based anesthesia on interventricular synchronization in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass

Abstract

Objective To evaluate the effect of sevoflurane-based anesthesia on the interventricular synchronization in the patients undergoing coronary artery bypass grafting(CABG)with cardiopulmonary bypass(CPB). Methods Twenty-four American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients, aged 52-75 yr, with body mass index of 17-31 kg/m2, with body surface area of 1.7-2.2 m2 , of New York Heart Association Ⅱ or Ⅲ, with left ventricular ejection fraction(LVEF)≥45%, scheduled for elective CABG with CPB, were divided into 2 groups(n=12 each)using a random number table: propofol combined with remifentanil anesthesia group(group C)and sevoflurane combined with propofol and remifentanil anesthesia group(group S). After induction of general anesthesia, the patients were endotracheally intubated and mechanically ventilated.Anesthesia was maintained by IV infusion of propofol, remifentanil and cisatracurium, and the cerebral state index value was maintained at 40-60.In group S, the patients inhaled sevoflurane(the end-tidal concentration was 1.80% for 50-59 yr and 1.60% for 60-75 yr)for 60 min starting from 15 min after termination of CPB.After induction of anesthesia and before splitting of sternum, immediately before inhaling sevoflurane and at 30 and 60 min of sevoflurane inhalation, heart rate, cardiac index, LVEF, right ventricular eject fraction, QRS width and interventricular mechanical delay were recorded, and the occurrence of interventricular dyssynchrony was recorded. Results There were no significant differences between group C and group S in the heart rate, cardiac index, LVEF, right ventricular eject fraction, QRS width, interventricular mechanical delay or incidence of interventricular dyssynchrony(P>0.05). Conclusion Sevoflurane-based anesthesia exerts no marked effect on interventricular synchronization in the patients undergoing CABG with CPB. Key words: Anesthetics, inhalation; Coronary artery bypass; Cardiac pacing, artificial; Heart ventricles