Comparison of the cardiovascular effects of isoflurane and sevoflurane as measured by magnetic resonance imaging in children with congenital heart disease

• Published in: Journal of clinical anesthesia 2008-02, Vol.20 (1), p.40-44
• Main Authors: Dalal, Priti G., MD, FRCA, Corner, Andrew, FRCA, Chin, Chris, MRCP, FRCA, Wood, Carine, MD, FRCA, Razavi, Reza, MD, MRCP, MRCPCH
• Format: Article
• Language: English
• Subjects: Anesthesia; Anesthesia & Perioperative Care; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthetics, Inhalation - pharmacology; Biological and medical sciences; Blood Pressure - drug effects; Cardiac magnetic resonance imaging; Cardiovascular disease; Child; Child, Preschool; Congenital diseases; Cross-Over Studies; Ejection fraction; Heart Defects, Congenital; Heart rate; Heart Rate - drug effects; Hemodynamics - drug effects; Humans; Infant; Isoflurane; Isoflurane - pharmacology; Magnetic Resonance Imaging; Medical sciences; Methyl Ethers - pharmacology; Pain Medicine; Patients; Pediatric; Research Design; Respiration, Artificial; Sevoflurane; Single-Blind Method; Variance analysis
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2007.08.004

Abstract Study Objective To compare the cardiovascular effects of isoflurane and sevoflurane at minimum alveolar concentration (MAC) = 1 in children with congenital heart disease using cardiac magnetic resonance imaging. Design Randomized, crossover, single-blinded study. Setting Tertiary-care teaching hospital. Patients 10 pediatric patients with congenital heart diseases scheduled to undergo cardiac magnetic resonance studies. Interventions Patients were randomized to receive either isoflurane or sevoflurane as the “first inhalation agent.” After a period or more than 20 minutes, they were crossed over to receive the “second inhalation agent.” Measurements Heart rate, mean arterial pressure (MAP), cardiac index, stroke volume index, and ejection fraction (EF) at one MAC for both agents were all recorded. Main Results Both isoflurane and sevoflurane caused a significant decrease in MAP from the baseline ( P = 0.013). The mean values (±SD) of stroke volume (mL), cardiac index (L min−1 m−2 ), and EF (%) for isoflurane versus sevoflurane were 21.5 (±9.2) versus 19.6 (±6.2), 4.1 (±1.2) versus 3.7 (±0.87), and 64.2 (±14.5) versus 62.5 (±13.8), respectively. Conclusion Both isoflurane and sevoflurane were found to be comparable in terms of cardiovascular effects.