The Effect of Sevoflurane Versus Isoflurane on Vasopressor Need

Study Overview
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Brief Summary
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Aim of this study is to determine the effect of isoflurane versus sevoflurane on blood pressure and systemic vascular resistance.

Detailed Description
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In modern anesthesia a variety of volatile anesthetics is available. In cardiac anesthesiology both isoflurane and sevoflurane are frequently used. At present the number of studies comparing the influence of isoflurane and sevoflurane on blood pressure and systemic vascular resistance is limited. Moreover, the results presented in the available literature are inconsistent. The decision as to which of both volatiles should be used during cardiac surgery is not evidence-based, but is based on personal preference of the anesthesist. The most reliable way to compare the effects of isoflurane and sevoflurane on blood pressure and systemic vascular resistance is a randomized controlled trial in patients during Cardiopulmonary bypass (CPB).

Official Title
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The Effect of Sevoflurane Versus Isoflurane on Vasopressor Need

Conditions
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Hypotension

Intervention / Treatment
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* Drug: Sevoflurane and isoflurane


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: competent adult patients (18 years or older)undergoing elective coronary artery bypass grafting with the use of the cardiopulmonary bypass. Exclusion Criteria: Patients undergoing valve surgery or combined surgical procedures (e.g. coronary artery bypass grafting in combination with valve reconstruction. uncontrolled hypertension a poor left ventricular function renal failure a body mass index of > 25 history of cerebrovascular accident, transient ischemic accident or carotid artery stenosis.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Sevoflurane<br>Administration of the volatile anesthetic Sevoflurane. | Drug: Sevoflurane and isoflurane<br>* Patients will be randomized to a 10 minute treatment with isoflurane, followed by a wash-out period, followed by a 10 minute treatment with sevoflurane, or the other way round.<br>* Other names: Sevorane/isoflurane;|
| Active Comparator: Isoflurane<br>Administration of the volatile anesthetic Isoflurane. | Drug: Sevoflurane and isoflurane<br>* Patients will be randomized to a 10 minute treatment with isoflurane, followed by a wash-out period, followed by a 10 minute treatment with sevoflurane, or the other way round.<br>* Other names: Sevorane/isoflurane;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total amount of the vasopressor phenylephrine that is needed to maintain blood pressure above 60 mmHg during 10 minutes of Cardiopulmonary bypass. |  | 10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean blood pressure throughout the 10 minute periods, the need for a stronger vasopressor (norepinephrine) and the inability to keep mean blood pressure below 75 mmHg at MAC 0.6. |  | 10 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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hypotension, low blood pressure, vasopressor need