Effect of inhalation bolus dose sevoflurane versus intravenous bolus dose propofol on cardiac parameters during attenuation of hemodynamic stress response : a doppler study

Abstract EN

Background Both sevoflurane and propofol were used to control surgical hemodynamic responses.

This study was carried out to compare the effect of inhalation bolus dose sevoflurane and bolus dose propofol on cardiac parameters using an esophageal Doppler monitor.

Methods Sixty patients scheduled for elective herniorrhaphy were randomized into two groups: group S (n = 30) and group P (n =30).

When a positive sympathetic response occurred [defined as a 15% increase in the heart rate (HR) and the mean arterial pressure (MAP)], patients in group S received an inhalation bolus of sevoflurane 8 vol% in 6 l/min O2, whereas patients in group P received bolus propofol 300mcg/kg/min.

Both boluses were maintained until MAP and HR reverted to baseline measurements.

Esophageal Doppler was inserted immediately after intubation.

Cardiac parameters, cardiac output, cardiac index, stroke volume, stroke volume index, peak velocity, and flow time corrected, were recorded 10 min after intubation (T0), which were considered as baseline values, with the occurrence of a sympathetic response (T1) and when MAP and HR reverted to baseline values (T2).

Results There was a significant reduction (Po0.05) in the cardiac parameters in group P compared with group S.

Conclusion The present study showed that inhalation bolus dose sevoflurane attenuated hemodynamic responses similar to those with propofol with less myocardial depressant effects and in a shorter duration of time.