The Impact of Sevoflurane and Propofol Anesthesia on Cerebral Blood Flow in Pediatric Open Cardiac Surgery, a Comparative Randomized Study

Taman, Hani I.

doi:10.23880/accmj-16000165

Cited by 1 publication

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“…Previous studies showed that propofol causes a global decrease in regional cerebral blood flow more than the sevoflurane. [23,26] In spite of the association between intraoperative cerebral oxygen desaturation and postoperative cognitive dysfunction, stroke, and prolonged hospital stay, [27][28][29] there was no any desaturation in patients with a postoperative neurological complication in the present study as measured by NIRS and the regional cerebral oxygenation was maintained as the preoperative, intraoperative and postoperative range. There are limitations to the present study.…”

Section: Discussioncontrasting

confidence: 52%

“…[21] The sevoflurane maintains cerebral hemodynamics as reported by a study that showed propofol decreases the maximum cerebral blood flow velocity, mean cerebral blood flow velocity, and mean arterial blood flow more than sevoflurane. [23] Experimental studies show that cerebroprotective effect of inhalation anesthetic agents may be related to the preconditioning [24] which attenuate apoptosis and necrosis of cerebral neurons, thereby reducing neurological dysfunction after ischemia. Also, the inhalation agents provide the stability of hemodynamics and therefore maintain the adequate perfusion and oxygenation of the organs, [25] and improve the recovery and survival of patients after surgery.…”

Section: Discussionmentioning

confidence: 99%

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Comparison the Cerebroprotective Effect of Sevoflurane and Propofol in Patients with Carotid Artery Stenosis Undergoing Coronary Artery Bypass Grafting: A Randomized Clinical Study

Nasr,

Soliman

2024

IJACM

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Objective: The Objective of the study was to evaluate the perioperative cerebral protective effect of sevoflurane and propofol in patients with carotid artery stenosis undergoing coronary artery bypass grafting. Materials and Methods: A randomized clinical study included 200 patients with preoperative carotid artery stenosis <50% scheduled for cardiac surgery with cardiopulmonary bypass. The patients were classified into 2 groups (each=100), Sevoflurane group: The patients received sevoflurane (concentration 1% to 4%) as an inhalational agent. Propofol group: The patients received propofol infusion (4-6 mg/kg/hr). The sevoflurane and propofol were given during the whole procedure (before, during, and after cardiopulmonary bypass). The monitors included heart rate, mean arterial blood pressure (MAP), central venous pressure and cerebral near-infrared spectroscopy (NIRS), the incidence of postoperative cognitive dysfunction and stroke. Results: There was no significant difference in the perioperative heart rate, mean arterial blood pressure, central venous pressure, and the right or left regional cerebral oxygen saturation between the two groups (P>0.05). The incidence of postoperative neurological complication was significantly lower with sevoflurane than propofol (P=0.012). The incidence of delirium was significantly lower with sevoflurane than propofol (P=0.023). The incidence of stroke was lower with sevoflurane than propofol, but the difference was insignificant (P=0.682). The ICU and hospital length of stay were shorter with sevoflurane than propofol (P=0.013, P=0.033 respectively). Conclusions: The sevoflurane was associated with a lower incidence of postoperative cognitive dysfunction than propofol in patients with carotid artery stenosis undergoing coronary artery bypass grafting.

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