Comparative Study between Halothane, Isoflurane and Sevoflurane in Ischemic Patients Undergoing Non-Cardiac Surgery | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 174, Volume 100, Issue 1, July 2025, Page 3761-3767 PDF (554.59 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2025.448756 | ||||
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| Abstract | ||||
| Background: Volatile anesthetics offer myocardial protection during cardiac surgery by reducing ischemia-reperfusion injury and surgical stress response. Their impact on outcomes in ischemic heart disease (IHD) patients remains under investigation, with agents like sevoflurane showing favorable cardiac effects compared to older anesthetics. Objective: To compare and clinically evaluate the use of halothane, isoflurane and sevoflurane in ischemic heart diseases patients undergoing non-cardiac surgery. Patients and methods: This prospective clinical study was carried out on 75 patients known to have IHD scheduled for non-cardiac elective surgery. They were randomized into 3 equal groups which received either halothane, isoflurane or sevoflurane as maintenance anesthesia. Hemodynamics and cardiac enzymes were monitored perioperatively. Results: Sevoflurane maintained a steady heart rate, while halothane caused a slight decrease and isoflurane a mild increase. Postoperative CK-MB levels were significantly elevated in the halothane group, with lower levels observed in the isoflurane and sevoflurane groups. Troponin levels increased with halothane but remained unchanged with isoflurane and sevoflurane, suggesting improved cardiac protection with the latter agents. Conclusion: In cardiac patients undergoing non cardiac surgery, sevoflurane and isoflurane were comparable with respect to the incidence and severity of intra- and postoperative myocardial ischemia and in the frequency of adverse cardiac outcomes while halothane was linked to increased cKMB and troponin levels, indicating higher cardiac stress. | ||||
| Keywords | ||||
| halothane; isoflurane; sevoflurane; ischemic heart disease; troponin | ||||
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