Influence of Anesthetics on Cardiac Index and Metabolic Outcomes in Mitral and Aortic Valve Replacement in Adults: A Randomized Clinical Study
Baiterek B.A. Mustafin A.
April 2023Brieflands
Anesthesiology and Pain Medicine
2023#13Issue 2
Background: Cardiac index (CI) and metabolic response to surgery are important indicators of the course of the intraoperative period. Objectives: This study aimed to determine the effect of sevoflurane, isoflurane, and propofol on CI and metabolic outcomes during aortic and mitral valve replacement in adults. Methods: In this single-center prospective randomized controlled clinical study, a total of 75 patients were randomly assigned into 3 groups according to the type of anesthesia: the propofol group (n = 25), the sevoflurane group (n = 25), and the isoflurane group (n = 25). Cardiac stroke volume (SV) was determined by intraesophageal echocardiography (SV = end-diastolic volume – end-systolic volume). Cardiac output (CO) and CI were calculated according to the formulas. Oxygen consumption during surgery = CI × arteri-ovenous difference. Indirect calorimetry was used to determine energy expenditure during anesthesia using a spirometry device. Results: The use of anesthetics did not change CI. Cardiac index decreased from 3 to 2.9 L/min/m2 in the propofol group, increased from 3.1 to 3.2 L/min/m2 in the sevoflurane group, and decreased from 2.9 to 2.7 L/min/m2 in the isoflurane group. Compared to inhaled anesthetics, propofol significantly reduced VO2 from 179.1 to 135.7 mL/min/m2 . Propofol reduced energy expenditure from 1483.7 to 1333.5 kcal. Conclusions: Volatile anesthetics, propofol has practically no effect on CI in an uncomplicated surgery. Anesthesia with propofol is associated with lower VO2 and better oxygen delivery to tissues. Energy consumption during propofol anesthesia decreases.
Energy Expenditure , Hemodynamics , Isoflurane , Oxygen Consumption , Propofol , Sevoflurane
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Astana Medical University, Nur-Sultan, Kazakhstan
Departments of Anesthesiology, Resuscitation and Intensive Care Unit Medical Centre, Hospital of President’s Affairs Administration of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
Departments of Anesthesiology, Resuscitation and Intensive Care Unit, City Multidisciplinary Hospital No. 2, Nur-Sultan, Kazakhstan
Department of Anesthesiology and Intensive Care, Astana Medical University, Nur-Sultan, Kazakhstan
Astana Medical University
Departments of Anesthesiology
Departments of Anesthesiology
Department of Anesthesiology and Intensive Care
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