A COMPARATIVE STUDY OF HEMODYNAMICS AND CARDIOPROTECTIVE EFFECTS OF SEVOFLURANE & ISOFLURANE IN PATIENTS UNDERGOING OFF PUMP CORONARY ARTERY BYPASS GRAFTING
Journal Title: IJSR-International Journal Of Scientific Research - Year 2017, Vol 6, Issue 7
Abstract
Background: Off pump coronary artery bypass grafting (CABG) avoids the post-operative complications which are related to on pump CABG. But off pump CABG is also associated with hemodynamic instability. Sevourane and Isourane in addition to Fentanyl & neuromuscular blocking agents are considered safe during off pump CABG. They have been reported to exert myocardial protective effects by decreasing the concentration of cardiac enyzymes & improving the heart functions. Methods: Fifty patients with Left ventricular EF>40% were given sevourane (gp A n=25) or isourane (gp B n=25) after induction with etomidate, fenanyl, midazolam & rocuronium in patients undergoing off pump CABG. Hemodynamics were assessed with Edwards Flo Trac continuous cardiac output monitor. Statistical analysis was done by using student t test and paired t test. A p value of less than 0.05 was considered statistically signicant and p value > 0.05 was not signicant. Results: Both agents showed favourable intra-operative hemodynamics. There was a tendency to decrease in B.P & H.R with each volatile agent but comparatively hemodynamics were more stable in the sevourane group. However these ndings were not statistically signicant. Time taken for eye opening & verbal command was signicantly earlier in sevourane group (3.37 ± 0.95 hr) as compared to isourane group (3.99 ± 0.98 hr) with a p value =0.027. Extubation was also earlier in the sevourane group (7.54 ±1.58 hr) as compared to isourane group (8.56±1.99 hr) with a p value =0.049. Conclusion: Sevourane provided a better hemodynamic prole in terms of Heart rate, Blood pressure, cardiac index and enzymes levels even though the difference was not found to be statistically signicant. Also sevourane provided early awakening & extubation which was statistically signicant as compared to isourane.
Authors and Affiliations
Dr Sushila Meena, Dr Indu Verma, Dr C. K Vyas, Dr Reema Meena
Keywords
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