İzofluran ve sevofluran klinik özelliklerinden dolayı kalp cerrahisinde yaygın olarak kullanılmakta olmasına karşın, pulmoner hipertansif mitral darlıklı olgularda pulmoner ve kardiyovasküler etkileri ile ilgili yeterli çalışma bulunamamıştır. Mitral darlığı nedeniyle kapak replasmam yapılacak pulmoner hipertansif 40 olgu rastgele izofluran (Gi, n=20) ve sevofluran (Gs, n=20) gruplarına ayrıldı. İndüksiyon sonrası anestezi, Gi, grubunda 1 MAK izofluran ve Gs grubunda 1 MAK sevofluran ile sağlandı. Anestezi indüksiyonundan önce (t0), entübasyon sonrası (t1) ve kanülasyon başlamadan hemen önce (t2); santral venöz basınç (SVB), ortalama pulmoner arter basıncı (OPAB), pulmoner kopiller oklüzyon basıncı (PKOB), kardiyak indeks (Kİ), pulmoner vasküler rezistans indeksi (PVRİ) ve sistemik vasküler rezistans indeksi (SVRİ) saptandı. Kalp hızı (KH) ve ortalama arter basıncı (OAB) ise yukarıdaki ölçüm zamanlarına ek olarak insizyon (ti) ve sternotomi (ts) sırasında kaydedildi. KH, gruplar arası değerlendirmede sadece t2'de farklı bulunurken, grup içi değerlendirmede ise Gs'de t0'a göre t2'de istatistiksel olarak anlamlı bir düşüş vardı (p

Although isoflurane and sevoflurane are widely used in cardiac surgery for their clinical properties, sufficient studies on their cardiovascular and pulmonary effects in mitral stenotic patients with pulmonary hypertension have not been found. Forty patients with mitral stenosis and pulmonary hypertension, who were undergoing mitral valve replacement surgery, were randomly divided into Isoflurane Gi, n=20) and Sevoflurane (Gs, n=20) groups. After anaesthesia induction, the maintenance of anaesthesia was provided with 1 MAC izoflurane in Gi and 1 MAC sevoflurane in Gs. Hemodynamic measurements, central venous pressure (CVP), mean pulmonary arterial pressure (MPAP), pulmonary capillary wedge pressure (PCWP), cardiac index (CI), pulmonary vascular resistance index (PVRI) and systemic vascular resistance index (SVRI), were performed before anaesthesia induction (t0), after intubation (t1), and just before cardiopulmonary bypass (t2). Heart rates (HR) and mean arterial pressure (MAP) were also determined t0, t1, and t2 as well as during incisron (ti) and sternotomi (ts) In inter-group evaluation, HR were found to be different at t2 (p<0.05). In-group evaluation, there was statistically significant decrease at t2 compared to t0 in Gs. Inter-group evaluation revealed no significant difference in the other hemodynamic measurements. In-group evolution, MAP, MPAP, PCWP and CI decreased at t1 and t2 compared to t0 in both groups, but CVP declined only at t2 compared to t0. As a result, 1 MAC isoflurane and sevoflurane used in mitral stenotic patients with pulmonary hypertension caused a decrease in MAP, MPAP, and CVP, which is not necessary to be corrected and the decrease in CI was clinically acceptable. According to results of the study, both agents have been thought to be convenient to be used in patients with mitral stenosis with pulmonary hypertension.