Article Data

  • Views 212
  • Dowloads 0

Original Research

Open Access

Haemodynamic changes after induction of anaesthesia with sevoflurane vs. propofol


1,Clinical Department of Anaesthesiology and Intensive Therapy University Medical Centre Ljubljana

2,Clinical Department of Thoracic Surgery University Medical Centre Ljubljana

DOI: 10.22514/SV62.102011.7 Vol.6,Issue 2,October 2011 pp.52-57

Published: 31 October 2011

*Corresponding Author(s): IZTOK POTOČNIK E-mail:


Inhalation induction with sevoflurane would appear to offer several objective advantages compared to induction with propofol. In our study, the hemodynamic results of sevoflurane vs. propofol induction in patients undergoing thoracotomy were studied. In a prospective, randomized, blinded study 24 patients were randomly allocated to one of 2 groups: sevoflurane (S) and propofol (P) (n=12 each). For hemodynamic monitoring the LIDCO plus system was used. Patients in group S were induced into anaesthesia with sevofluran, remifentanil and vecuronium, whereas patients in group P with propofol, remifentanil and vecuronium. The anaesthesia was maintained with the same agents. Hemodynamic stability was guided using a special algo-rithm. The goal was oxygen delivery index (DO2I) > 500 mL min-1 m-2. According to the algorithm, patients received colloids or vasoactive drugs. Hemodynamic parameters were recorded before induction, 3 minutes after induction and 3 minutes after intubation and commencement of one lung ventilation. The consumption of vasoactive drugs and colloids and the time from the beginning of induction to intubation were documented. No statistically significant differences in measured hemodyna-mic parameters, remifentanil and colloid consumption between the S and P group were found. In group P, statistically more ephedrine was used (S: 4.2, P:20.8, p<0.05). Patients undergoing thoracotomy induced with sevoflurane are circulatory more stable than those induced with propofol.


thoracotomy, one lung ventilation, cardiac index, Systemic Vascular Resistance Index (SVRI)

Cite and Share

IZTOK POTOČNIK,VESNA NOVAK JANKOVIĆ,TOMAŽ ŠTUPNIK,BORIANA KREMŽAR. Haemodynamic changes after induction of anaesthesia with sevoflurane vs. propofol. Signa Vitae. 2011. 6(2);52-57.


1. Thwaites A, Edmends S, Smith I. Inhalation induction with sevoflurane: a double-bind comparison with propofol. Br J Anaesth 1997;78:356–61.

2. Patel SS, Goa KL (April 1996). Sevoflurane. A review of its pharmacodynamic and pharmacokinetic properties and its clinical use in general anaesthesia. Drugs 1996; 51(4):658–700.

3. Abe K, Shimizu T, Takashina M, Shiozaky H, Yoshiya Il. The effects of propofol, isoflurane, and sevoflurane on oxygenation and shunt fraction during one lung ventilation. A & A 1998;87:1164-9.

4. Pruszkowski O. Effects of propofolvssevoflurane on arterial oxygenation during one lung ventilation. British Journal of Anasthesia 1998:539-44.

5. Beck DH, Doepfmer UR, Sinemus C, Bloch A, Schenk MR, Kox WJ. Effects of sevoflurane and propofol on pulmonary shunt fraction during one-lung ventilation for thoracic surgery. Br J Anaesth 2001;86(1):38-43.

6. Rogers SN, Benumof JL.Halothane and Isoflurane Do Not Decrease Pao2 during One-Lung Ventilation in Intravenously Anesthetized Pati-ents. A & A 1985;64(10): 946-54.

7. Mulligan MS, Vaporciyan AA, Warner RL, Jones ML, Foreman KE, Miyasaka M, et al. Compartmentalized role for leukocytic adhesion molecules in lung inflammatory injury. J Immunol 1994;154:1350–63.

8. De Conno E, Steurer MP, Wittlinger M, Zalunardo MP, Weder W, Schneiter D, et al. Anesthetic-induced improvement of the inflammatory response to one lung ventilation. Anesthesiology 2009;110(6):1316-26.

9. Hofstetter C, Boost KA, Flondor M, Basagan-Mogol E, Betz C, Homann M, et al. Anti-inflammatory effects of sevoflurane and mild hypot-hermia in endotoxemic rats. ActaAnaesthesiolScand 2007;51:893-9.

10. Steurer M, Schlaepfer M, Steurer M, Z’graggen BR, Booy C, Reyes L, et al. The volatile anaesthetic sevoflurane attenuates lipopolysacc-haride-induced injury in alveolar macrophages. Clin ExpImmunol 2009;155(2):224-30.

11. Kersten JR, Brayer AP, Pagel PS, Tessmer JP, Warltier DC. Perfusion of ischemic myocardium during anesthesia with sevoflurane. Ane-sthesiology 1994;81(4):995-1004.

12. Hill RC, Jones DR, Vance RA, Kalantarian B. Selective lung ventilation during thoracoscopy: effects of insufflations on hemodynamics. Ann ThoracSurg 1996;61: 945-8.

13. Ohtsuka T, Imanaka K, Endoh M, Kohno T, Nakajima J, Kotsuka Y, Takamoto S. Hemodynamic effects of carbon dioxide insufflations under single-lung ventilation during thoracoscopy. Ann ThoracSurg 1999;68:29-33.

14. Rhodes A, Sunderland R. Arterial pulse pressure analysis: The LiDCO. In: Pinsky MR, Payen D, editors. Functional Hemodynamic Monito-ring. Update in Intensive Care and Emergency Medicine 42. Berlin, Heidelberg: Springer-Verlag; 2004.p. 183-92.

15. Kapoor PM, Kakani M, Chowdhury U, Choudhury M, Lakshmy, Kiran U. Early goal-directed therapy in moderate to high-risk cardiac surgery patients. Ann Card Anaesth 2008;11:27-34.

16. Reuter DA, Goresch T, Goepfert MSG, Wildhirt SM, Kilger E, Goetz AE. Effects of mid-line thoracotomy on the interaction between mecha-nical ventilation and cardiac filling during cardiac surgery. BJA 2004;92(6):808-13.

17. Hensley FA, Martin DE, Gravlee GP. A practical approach to cardiac anesthesia, 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2008.p. 43.

18. Trca S, Krska Z, Kittnar O, Mlcek M, Demes R, Danzig V, et al. Haemodynamic response to thoracoscopy and thoracotomy. Physiological Research 2010;59(3):1-8.

19. Malant TP, Dinardo JA, Isner RJ, Frink EJ, Golderg M, Fenster PE, et al. Cardiovascular effects of sevoflurane compared with those of isoflurane in volunteers. Anesthesiology 1995;83(5):918-28.

20. Ebert TJ, Harkin CP, Muzi M. Cardiovascular responses to sevoflurane: a review. A & A 1995;81(6):11-22.

21. Hikasa Y, Okuyama K, Kakuta T, Takase K, Ogasawara SS. Anesthetic potency and cardiopulmonary effects of sevoflurane in goats: comparison with isoflurane and halothane. Can J Vet Res 1998 October;62(4):299–306.

22. Fujita Y, Yamasaki T, Takaori M, Sekioka K. Sevofluraneanaesthesia for one lung ventilation with PEEP to the dependent lung in sheep: effects on right ventricular function and oxygenation. Can J Anaesth 1993;40(12):1195-200.

23. Claeys MA, Gepts E, Camu F. Haemodynamic changes during anaesthesia induced and maintained with propofol. Br J Anaesth 1988;60(1):3-9.

24. Ilkiw JE, Pascoe PJ. Cardiovascular effects of propofol alone and in combination with ketamine for total intravenous anesthesia in cats. AJVR 2003;64(9):913-7.

25. Aun CST, Sung RYT, O’meara ME, Short TG, Oh TE. Cardiovascular effects of i.v. induction in children: comparison between propofol and thiopentone. Br J Anaesth 1993;70(6):647-53.

26. Stephan H, Conntag H, Schenk HD, Kettler D, Khambata HJ. Effects of propofol on cardiovascular dynamics, myocardial blood flow and myocardial metabolism in patients with coronary artery disease. Br J Anaesth 1986 Sep;58(9):969-75.¬

27. Goodchild CS, Chir B, Serrao JM. Cardiovascular effects of propofol in anaesthetized dog. Br J Anesth 1989;63:87–92.

28. Zheng D, Upton RN, Martinez AM, Grant C, Ludbrook GL. The influence of the bolus injection rate of propofol on its cardiovascular effects and peak blood concentration in sheep. A & A 1998;86:1109-15.

29. Filipovic M, Wang J, Michaux I, Hunziker P, Skarvan K, Seeberger MD. Effects of halothane, sevoflurane and propofol on left ventricular diastolic function in humans during spontaneous and mechanical ventilation. Br J Anaesth 2005;94(2):186-92.

30. Fredman B, Nathanson MH, Smith I, Wang J, Klein K, White PF. Sevoflurane for outpatient anesthesia: a comparison with propofol. A & A 1995;81:823-8.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time