Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery

The effect of sevoflurane on the character of metabolic disordersin the early postoperative period in patients with heart valves diseasesoperated with cardiopulmonary bypass

Authors: G.V. Yudin, M.M. Rybka, M.V. Lomakin, A.A. Goncharov

Bakoulev National Scientific and Practical Center for Cardiovascular Surgery, Ministry of Health of the Russia, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.


UDC: 616.12-007.1-089.8-78-089.5:615.211

Link: Clinical Physiology of Blood Circulaiton. 2017; 14 (2): 96-102

Quote as: Yudin G.V., Rybka M.M., Lomakin M.V., Goncharov A.A. The effect of sevoflurane on the character of metabolic disorders in the early postoperative period in patients with heart valves diseases operated with cardiopulmonary bypass. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2017; 14 (2): 96–102 (in Russ.). DOI: 10.24022/1814-6910-2017-14-2-96-102

Received / Accepted:  08.02.2017/16.02.2017

Full text:  


Objective: to study the effect of sevoflurane on the severity of metabolic disorders in the early postoperative period in patients with heart valves diseases, operated on cardiopulmonary bypass.
Material and methods. The study is a prospective, randomized, controlled trial. It included 60 patients divided into two groups of 30 people: group of total intravenous anesthesia (TIVA) and volatile anesthesia group (VA). In the postbypass period, admission to the intensive care unit, on the 3rd, 6th, 9th, 12th, 18th, 24th hours of the early postoperative period in patients determined the gas composition of arterial and venous blood, concentrations of glucose and serum lactate. Studied the dynamic of glycemia and lactatemia; compared concentrations of glucose and serum lactate between the groups of the study determined there was a correlation between lactate concentration and blood glucose levels; estimated number of complications, time of ventilation of lungs and tie of stay in intensive care unit of patients.
Results. After total intravenous anesthesia maximum glycemia in patients were observed from the 6th to the 12th hours of the early postoperative period, glucose concentration did not change (p>0.05), and accounted for 16.9±3.9 mmol/l, then it was reduced to 10.8±2.6 mmol/l to 24th hour (p<0.05). After sevoflurane anesthesia maximum blood glucose concentrations observed on the 6th hour of 16.7±4.2 mmol/l, then the glycemia decreased to 10.4±2.1 mmol/l to 24th hour. When comparing the levels of glycemia was statistically significant difference (p<0.05) in the concentration of glucose in the postbypass period, 8.0±2.3 mmol/l (TIVA) and 10.6±1.7 mmol/l (VA), at admission to the intensive care unite, 9.3±2.1 mmol/l (TIVA) and 10.6±1.7 mmol/l (VA), at the 12th hour postoperative period, 17.4±5.5 mmol/l (TIVA) and 14.3±3.7 mmol/l (VA). Concentration of serum lactate reached maximum values at the 6th hour of 8.6±3.5 mmol/l (VA) and 11.8±4.8 mmol/l (TIVA), the 12th hour 7.3±3.7 mmol/l (VA) and 10.0±3.7 mmol/l (TIVA), peaking at 9th hours of observation, 9.9±4.1 mmol/l (VA) and 12.7±4.9 mmol/l (TIVA). At this time in the group TIVA hyperlactatemia was significantly higher (p<0.05). It was not found correlation between the concentration of serum lactate with the level of glycemia in patients in group TIVA (p>0.05). In the group VA there was a correlation between concentrations of the investigated metabolites (p<0.05) from the 6th to the 18th houres of early postoperative period. The number of complications, time of artificial lung ventilation and time of stay of patients in the intensive care unit was lower after sevoflurane anesthesia (p<0.05).
Conclusion. Statistically significant difference of serum concentrations of lactate and glucose, the early decrease of glycemia in the group VA may indicate an improvement of microcirculation and reduction of the severity of hypermetabolism in the intraoperative period under the action of sevoflurane. In the study, we investigated the possibility of using sevoflurane as a means of prevention of severe metabolic disorders and organ disorders in the early postoperative period in patients with heart valves diseases, operated on cardiopulmonary bypass.


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About Authors

  • Yudin Gennadiy Vyacheslavovich, Anesthesiologist-Intensivist;
  • Rybka Mikhail Mikhaylovich, MD, PhD, DSc, Chief of Anesthesiology Department;
  • Lomakin Maksim Viktorovich, Anesthesiologist-Intensivist;
  • Goncharov Andrey Andreevich, Resident Physician

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