Astana Medical University, Kazakhstan
Cardiac index (CI) and metabolic response to surgery are important indicators of the course of the intraoperative period. Objectives: This study aimed to determine the effect of sevoflurane, isoflurane, and propofol on CI and metabolic outcomes during aortic and mitral valve replacement in adults. Methods: In this single-center prospective randomized controlled clinical study, a total of 75 patients were randomly assigned into 3 groups according to the type of anesthesia: the propofol group (n = 25), the sevoflurane group (n = 25), and the isoflurane group (n = 25). Cardiac stroke volume (SV) was determined by intraesophageal echocardiography (SV = end-diastolic volume – end-systolic volume). Cardiac output (CO) and CI were calculated according to the formulas. Oxygen consumption during surgery = CI × arteri-ovenous difference. Indirect calorimetry was used to determine energy expenditure during anesthesia using a spirometry device. Results: The use of anesthetics did not change CI. Cardiac index decreased from 3 to 2.9 L/min/m2 in the propofol group, increased from 3.1 to 3.2 L/min/m2 in the sevoflurane group, and decreased from 2.9 to 2.7 L/min/m2 in the isoflurane group. Compared to inhaled anesthetics, propofol significantly reduced VO2 from 179.1 to 135.7 mL/min/m2. Propofol reduced energy expenditure from 1483.7 to 1333.5 kcal. Conclusions: Volatile anesthetics, propofol has practically no effect on CI in an uncomplicated surgery. Anesthesia with propofol is associated with lower VO2 and better oxygen delivery to tissues. Energy consumption during propofol anesthesia decreases.
I am Baiterek Bekzat Askaruly, I was born in 1991, I currently live in Astana, Republic of Kazakhstan. In 2008, I graduated from school No. 10 in Astana. In 2009, I entered the Kazakh National Medical University in Almaty, and then I completed this bachelor's degree in 2014 at the Astana Medical University. In 2016, I completed my internship at this university in the field of therapy. I studied residency at the National Scientific Medical Center for 3 years. I studied residency in the field of Anesthesiology and resuscitation, and graduated in 2019. Currently, I am a 3-year doctorate student and work as an anesthesiologist and resuscitator in Astana City Hospital No. 2