Sevoflurane versus total intravenous anesthesia for cardiac surgery

Objective: To compare the effect of sevoflurane and total intravenous anesthesia (TIVA) on anesthesia induction, maintenance and postoperative recovery in patients receiving cardiac surgeries. Methods: Overall, 80 patients admitted in our hospital to receive cardiac surgery between January 2015 and January 2017 were enrolled in our study. They were randomized into the sevoflurane anesthesia (SA) group (n=40) and the total intravenous anesthesia (TIVA) group (n=40) in terms of a random number table. Between the two groups, anesthesia induction parameters including time to pain-free, loss of eyelash reflex and intubation; anesthesia maintenance parameters including cardiopulmonary bypass time, anesthesia time, operation time, intraoperative mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO2), the total dosage of vasoactive agents (dopamine and nitroprusside) and urine volume; other postoperative outcomes including length of hospital stay, adverse reactions, complications and return of spontaneous heartbeat were compared. Results: The time to pain-free, loss of eyelash reflex and intubation in the SA group were strikingly shorter than those in the TIVA group (P=0.031, P=0.045, P=0.016). MAP before intubation and HR before intubation, immediately and 3min after intubation were observed to be lower in the SA group (P=0.023, P=0.033, P=0.025, P=0.036). The time for cardiopulmonary bypass (CPB), anesthesia and operation were significantly shorter (P=0.031, P=0.018, P=0.017), urine volume was more (P=0.009), and length of hospital stay was shorter (P=0.022) in the SA group than in the TIVA group. Besides, a lower rate of return of spontaneous heartbeat was also observed in the SA group (27.5%, 11/40) as compared with that of the TIVA group (80.0%, 32/40; P<0.001). Between the groups, no statistical differences were found in the incidences of postoperative adverse reactions and complications (P>0.05). Conclusion: Sevoflurane anesthesia requires shorter time for anesthesia induction and maintenance, and it improves the postoperative body rehabilitation in patients undergoing cardiac surgery as compared with total intravenous anesthesia.