Safe inhalational anesthetics in patients with coronary artery disease: Effects of sevoflurane and desflurane on ischemia-modified albumin levels

INTRODUCTION: Sevoflurane and desflurane are commonly used anesthetic agents with known cardiac side effects. Ischemia-modified albumin (IMA) is a useful biomarker that increases in cardiac conditions. This study investigates the effects of desflurane and sevoflurane on cardiac parameters and IMA levels in patients with coronary artery disease (CAD).
METHODS: Sixty CAD patients aged over 18 years scheduled for elective surgery were enrolled. Patients were randomly divided into two groups: group I, desflurane (D) (n=30) and group II, sevoflurane (S) (n=30). Pre- and post-operative cardiac parameters were recorded for each patient. IMA measurement in serum was determined spectrophotometrically.
RESULTS: Postoperative IMA levels were significantly higher than preoperative IMA levels in both groups (p<0.001 for both). The rate of change between post- and pre-operative IMA levels was significantly lower in group S than in group D (p<0.001). Postoperative heart rate (HR) and mean arterial pressure (MAP) levels were significantly lower than preoperative HR and MAP levels in both groups (p<0.001), whereas no significant differences were found between the two groups with regard to pre- and post-operative HR and MAP levels.
DISCUSSION AND CONCLUSION: Sevoflurane is safer and has fewer cardiac side effects in CAD patients than desflurane. However, there is a need for comprehensive new studies evaluating large patient groups investigating this situation.