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BJA Advance Access originally published online on October 22, 2006
British Journal of Anaesthesia 2007 98(1):12-18; doi:10.1093/bja/ael277
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Effects of sevoflurane and propofol on left ventricular diastolic function in patients with pre-existing diastolic dysfunction

M. Filipovic1,*, I. Michaux1, J. Wang1, P. Hunziker2, K. Skarvan1 and M. Seeberger1

1 Department of Anaesthesia, University of Basel Hospital CH-4031 Basel, Switzerland
2 Medical Intensive Care Unit, Department of Internal Medicine, University of Basel Hospital CH-4031 Basel, Switzerland

*Corresponding author. E-mail: mfilipovic{at}uhbs.ch

Background. The effects of anaesthetics on left ventricular (LV) diastolic function in patients with pre-existing diastolic dysfunction are not well known. We hypothesized that propofol but not sevoflurane will worsen the pre-existing LV diastolic dysfunction.

Methods. Of 24 randomized patients, 23 fulfilled the predefined echocardiographic criterion for diastolic dysfunction. They received general anaesthesia with sevoflurane 1 MAC (n=12) or propofol 4 µg ml–1 (n=11). Echocardiographic examinations were performed at baseline and in anaesthetized patients under spontaneous breathing and under positive pressure ventilation. Analysis focused on peak early diastolic velocity of the mitral annulus (Ea).

Results. During spontaneous breathing, Ea was higher in the sevoflurane than in the propofol group [mean (95% CI) 7.0 (5.9–8.1) vs 5.5 (4.7–6.3) cm s–1; P<0.05], reflecting an increase of Ea from baseline only in the sevoflurane group (P<0.01). Haemodynamic findings were similar in both groups, but the end-tidal carbon dioxide content was more elevated in the propofol group (P<0.01). During positive pressure ventilation, Ea was similarly low in the sevoflurane and propofol groups [5.3 (4.2–6.3) and 4.4 (3.6–5.2) cm s–1, respectively].

Conclusions. During spontaneous breathing, early diastolic function improved in the sevoflurane but not in the propofol group. However, during positive pressure ventilation and balanced anaesthesia, there was no evidence of different effects caused by the two anaesthetics.


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E-letters:

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Effects of propofol and sevoflurane on left ventricular diastolic function
Olumuyiwa A Bamgbade, et al.
British Journal of Anaesthesia, 26 Feb 2007 [Full text]
Response to E-Letter by Bamgbade et al
Daniel Bolliger, et al.
British Journal of Anaesthesia, 30 Mar 2007 [Full text]

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