Comparison of postoperative complication incidences with different anaesthetic agents used in open heart surgery: a...

The choice of anaesthetic agent for open-heart surgery (OHS) may influence perioperative physiology and outcomes. This study compared the effects of sevoflurane and propofol on intraoperative parameters and postoperative complications.

A retrospective analysis was conducted on 202 patients undergoing OHS (propofol: n = 71; sevoflurane: n = 131). Demographic data, intraoperative variables (cardiopulmonary bypass [CPB] duration, aortic cross-clamp time, heparin dose, cardioplegia volume), serial arterial blood gas (ABG) values, and postoperative complications were collected. Statistical analysis included parametric/non-parametric tests and a generalised linear model.

Demographic and baseline characteristics were comparable between groups. No significant differences were found in CPB time, cross-clamp time, or heparin dose. Cardioplegia volume differed significantly (p = 0.025). ABG analysis revealed that pH and O₂ levels were not significantly influenced by anaesthetic type but were affected by gender and surgical phase. CO₂ levels were significantly influenced by anaesthetic type, gender, and time (p < 0.001). Rates of postoperative bleeding/reoperation (propofol: 4.29%; sevoflurane: 4.55%) and other complications showed no significant differences.

Both sevoflurane and propofol demonstrated comparable safety and efficacy in OHS, with no significant differences in major postoperative complications. However, anaesthetic choice and patient gender significantly influenced intraoperative CO₂ dynamics. These findings support the clinical equivalence of both agents while highlighting gender-specific physiological responses that may warrant consideration in perioperative management.