Comparison of effects of desflurane and sevoflurane on myocardial protection and inflammation in coronary artery bypass grafting surgery

The aim of this study is, in terms of intraoperative myocardial ischemia, to compare the effects of desflurane with sevoflurane to ST-segment changes, cardiac enzyme and tumour necrosis factor-alpha (TNF-alpha) values in patients undergoing coronary artery bypass grafting surgery (CABGS).Thirty-one patients undergoing elective CABGS were randomly allocated into two groups; in Group D desflurane and in Group S sevoflurane was administered. Remifentanil was administered at a constant infusion dose during the operation and depth of anesthesia was adjusted by modifying volatile anesthetics delivered fraction to achieve an anesthetic state with a bispectral index value in the range of 40-60. Hemodynamic parameters, ST-segment changes, cardiac output and minimum alveolar concentrations (MAC) were recorded. Blood samples were drawn for cardiac enzyme and TNF-alpha assay before induction of anesthesia andat intra- and postoperative time periods. Intraoperative and postoperative complications were recorded.Hemodynamic parameters, ST-segment changes, cardiac output and bispectral index values were similar between the two groups. Reduction of MAC values attributed to remifentanil were significantly higher in Group D than Group S. Creatine kinase-MB andtroponin-T values were similar between the groups. In Group D TNF-alpha levels at the postoperative 2nd hour was found significantly lower than Group S. The skin closure and postoperative 24th hour TNF-alpha values were lower than Group D.We conclude that, during the anesthesia for CABGS desflurane and sevoflurane protect the myocardium identically that can be detected by ST-segment changes, creatine kinase-MB and troponin-T levels and at the early postoperative period desflurane andsevoflurane blocks the inflammatory response similarly, which can be shown by TNF-alpha values.