Comparison of the effects of sevoflurane,desflurane and isoflurane against ischaemia/reperfusion injury in open heart surgery [Açik kalp cerrahi̇si̇nde uygulanan sevofluran,desfluran ve i̇zofluranin i̇skemi̇-reperfüzyon hasari üzeri̇ne etki̇leri̇ni̇n karşilaştirilmasi]

Objective: most of the investigations demonstrate that halogenated anaesthetics protect the myocardium against ischaemial reperfusion(i/r) injury by reducing the infarct size and providing a fast recovery of contractile functions during reperfusion. the aim of this study was to compare the effects of sevoflurane,desflurane and isoflurane on i/r injury during open heart surgery. method: following ethical committee approval,36 patients aged 25-75 years were included in this prospective,randomized study. the patients were randomly allocated to groups according to the volatile anaesthetics they received,sevoflurane (group s),desflurane (group d) and isoflurane (group i). inhalation agents were administered at i mac concentration from anaesthesia induction until the end of the operation,excluding the cpb period. all patients received infusion of remifentanil throughout the operation. haemodynamic variables (hr,map,cvp,co,ci,pap,pcwp,svr,pvr,sv,si),length of icu and hospital stay were recorded. laboratory parameters (ckmb,tnt,bnp) were obtained at five periods (t1 :after induction,t2:during cpb,t3:end of the operation,t4:postop 24th hrs,t5:postop 48th hrs) and il-6,il-10 were recorded at t1,t4,t5. results: map (t3,t5),cvp (t4,t5),pap,pcwp,svr,pvr (t3-t5) levels were decreased and hr (sevo,t3-t5),co,ci,sv,si (t3-t5) were increased in all groups according to the basal values. the values of ckmb and tnt (t2-t5),bnp and il-6 (t4,t5),il-10 (t4) were increased when compared with the basal values,but no difference was observed between the groups. there were no differences in blood and blood products,inotropic requirements,length of icu and hospital stay between the groups. blood sugar and insulin requirements were higher in the desflurane group compared to the other groups. conclusion: sevoflurane,desflurane and isoflurane have similar haemodynamic and cardiac protective effects in patients undergoing open heart surgery.