The echocardiographic assessment of left ventricular performance during sevoflurane and halothane anesthesia.
The cardiovascular effects of sevoflurane were studied and compared with those of halothane in 30 healthy patients. The patients were assigned to receive 1 MAC sevoflurane (n = 10), 2 MAC sevoflurane (n = 10) or 1 MAC halothane (n = 10) in N(2)O 2 l.min(-1) and O(2) 4 l.min(-1). The changes in left ventricular diastolic and systolic dimension (Dd and Ds), fractional shortening (FS), mean velocity of circumferential fiber shortening (mVcf), left ventricular diastolic and systolic volume (Vd and Vs), stroke volume (SV), ejection fraction (EF) and cardiac index (CI) were evaluated by echocardiography. Sevoflurane produced significant dose-dependent decreases in FS, mVcf, EF and SV, but no significant changes in Dd and Vd. Therefore, the decrease in SV was due mainly to the increase in left ventricular residual volume (Vs). One MAC halothane produced a more significant decrease in FS, mVcf, EF and SV, when compared to values obtained at 1 MAC sevoflourane ( P < 0.01). CI was more significantly decreased with 1 MAC halothane than with 1 MAC and 2 MAC sevoflurane ( P < 0.01). This was brought about by a slight decrease in HR with halothane and a slight increase in HR with sevoflurane, in addition to a smaller decrease in SV with sevoflurane than with halothane. This study suggests that sevoflurane may better preserve cardiac function as a pump in healthy patients, when compared to halothane.
Kasuda
H
H
Department of Anesthesiology, Jichi Medical School, Tochigi, Japan.
Akazawa
S
S
Shimizu
R
R