Dinko Tonković | PubMed Health

PubMed2003

Hemodynamic differences in sevoflurane versus propofol anesthesia.

The aim of the study was to compare the effect of sevoflurane and propofol anesthesia on myocardial contractility during laparotomic cholecystectomy using transesophageal echo-Doppler. In the study, 40 patients were randomized into two groups, depending on whether they received sevoflurane or propofol anesthesia. Heart rate, cardiac index, stroke volume, left ventricular ejection time and acceleration were measured 10 minutes after induction of anesthesia, 1 minute and 25 minutes after incision. The results were analyzed using paired t-test and ANOVA. Significantly lower values were found for all parameters after the initial measurement (p < 0.05). In the sevoflurane group, stroke volume decreased from 66 +/- 6.2 ml/beat to 65 +/- 6.4 ml/beat and to 63 +/- 5.6 ml/beat 1 minute and 25 minutes after incision respectively. In the propofol group changes were from 64 ml/beat to 58 +/- 10.5 ml/beat to 58 +/- 8.6 ml/beat. Stroke volume was significantly higher in the sevoflurane than in the propofol group (p < 0.05). Sevoflurane anesthesia allows a better hemodynamic stability during laparotomic cholecystectomy.

Adult↗

PubMed2002

Measuring cardiac output during dobutamine infusion after off-pump coronary artery bypass: comparison of transesophageal echo-Doppler and thermodilution.

AIM: To compare transesophageal echo-Doppler with thermodilution method for measuring cardiac output during dobutamine infusion after off-pump coronary artery bypass. METHOD: Using transesophageal echo-Doppler and thermodilution methods, we measured cardiac output in 30 patients after off-pump coronary artery bypass, immediately before and 5, 15, and 30 min after the introduction of continuous dobutamine infusion (3 microg/kg/min). Paired t-test and Bland-Altman analysis were used to compare the results obtained by two methods in this prospective study. RESULTS: Significant increase in cardiac output during dobutamine infusion was detected by both thermodilution (from 3.9 +/- 1.0 to 4.6 +/- 1.1 L/min; p < 0.001) and transesophageal echo-Doppler (from 3.8 +/- 1.2 to 4.8 +/- 1.4 L/min; p < 0.001). Initial measurement results of thermodilution and transesophageal echo-Doppler techniques showed clinically acceptable agreement, with a mean difference of only + 0.09 L/min (95% confidence interval (CI), 0.42 to + 0.61). Subsequently repeated measurements after 5, 15, and 30 min showed almost the same agreement between the methods. The highest mean difference between the initial and repeated measurements was found at 5 min after the introduction of dobutamine infusion (-0.29 L/min, 95% CI, -1.06 to + 0.48). CONCLUSION: Transesophageal echo-Doppler and thermodilution can be interchangeable as methods for measuring cardiac output after off-pump coronary artery bypass.

Adult↗