Comparison of the effects of sevoflurane anesthesia and total intravenous anesthesia on ventricular repolarization parameters in geriatric patients undergoing urologic surgery

Objective: The aim of this study was to compare the effects of sevoflurane inhalational anesthesia and propofol-based total intravenous anesthesia (TIVA) on ventricular repolarization parameters in geriatric patients undergoing elective urological surgery. Materials and Methods: A total of 57 patients, aged between 60 and 85 years and classified as ASA physical status I–II, who were scheduled for elective urological procedures, were included in this prospective observational study. Patients were evaluated in two groups: those who received sevoflurane for volatile anesthesia and those who received propofol-based TIVA. Twelve-lead electrocardiograms were recorded preoperatively and at the 60th postoperative minute to assess QTc, JTc, QTd, JTd, Tpe, and Tpe/QTc parameters. Results: QTc and JTc intervals showed a tendency to increase during surgery in both groups, but no significant difference was observed between them. In contrast, indices reflecting repolarization heterogeneity—QTd, JTd, Tpe, and Tpe/QTc—were found to increase more prominently in the sevoflurane group, whereas only limited changes were observed in the TIVA group. Conclusion: While sevoflurane and propofol-based TIVA similarly affected ventricular repolarization intervals in geriatric patients, TIVA provided a more stable and predictable profile with respect to repolarization heterogeneity. This finding suggests that TIVA may represent a safer anesthetic option in geriatric patients with elevated cardiac risk. Keywords: Geriatric patient, Sevoflurane, TIVA, Ventricular Repolarization,