Comparison Between Sevoflurane and Isoflurane Anesthesia in Off Pump Coronary Artery Bypass Grafting in Patients of COPD with Right and Left Ventricular Systolic Dysfunction

A total of 100 COPD patients having right and left ventricular systolic dysfunction underwent off pump CABG surgery were included in prospective, randomized, comparative, parallel group study with an aim to find out the effects of sevoflurane and isoflurane anaesthesia on changes in coronary sinus blood flow, right and left ventricular systolic function before and after off pump CABG. All the patients were randomly allocated into two groups to receive either sevoflurane or isoflurane 1 MAC for off pump CABG. ME four chamber, modified bi-caval view used before and after grafting for detection of coronary sinus diameter, coronary sinus blood flow (ml/min) and VTI in cm. LV and RV systolic functions measured by end diastolic volume (ml) and ejection fraction ( %). RV systolic functions were assessed by TAPSE and RVEF ( %). Demographic profile, preoperative CSD, CSA, CSBF, CSVTI, LVEDV, LVEF %, RVEF %, TAPSE between the groups were comparable. Postoperatively CSA area and CSBF showed insignificant difference in between two groups, whereas CSVTI were comparable between two groups; Changes in VTI was significant between pre and postoperative period both in case of between and within the groups. Postoperative RVEF % (p0.560) and TAPSE (p 0.530) also showed no significant difference between the groups, but within the group the changes were significant. Postoperative LVEDV and LVEF % between the groups showed no significant difference (p 0.659; p 0.965). CSBF, CSVTI, RVEF, TAPSE improved after CABG in both the groups along with more improvement in sevoflurane recipient COPD patients.