Effects of sevoflurane and desflurane on microcirculation during non-cardiac surgery

Objectives: Assessment of microcirculation is thought to be a surrogate of tissue perfusion and anesthetic drugs are known to alter the microcirculation in cardiac surgery patients, but their effects in less complicated non-cardiac surgery remain unknown. Our aim is to investigate the effects of sevoflurane and desflurane on the microcirculation parameters during non-cardiac surgery. Design: Prospective cohort study Setting: Hacettepe University Medical Faculty and Hospital Subjects: Patients with American Society of Anesthesiologists (ASA) score of I-II who underwent ≥2 hours of non-cardiac surgery were randomly divided into two groups: sevoflurane (n=20) and desflurane (n=19). Intervention: Sevoflurane or desflurane Main outcome measures: Demographic, hemodynamic (heart rate, mean arterial pressure) and laboratory parameters (hematocrit, hemoglobin, urea and creatinine) were measured. Microcirculation imaging was performed by using side stream dark field imaging. Results: There were no statistical differences in demographic, hemodynamic and laboratory parameters between groups. In the sevoflurane group, the proportion of perfused vessel (PPV) was slightly increased at the second hour intraoperatively compared to the post-induction period in small vessels (94.7% vs 93%, P=.036), but other parameters (microvascular flow index, total vascular density and perfused vascular density) were comparable in both measurement periods. In the desflurane group, all microcirculation parameters were comparable between post-induction period and second hour intraoperatively. Conclusions: Sevoflurane anesthesia slightly increases the PPV in small vessels, whereas desflurane has no effect on microcirculation parameters in ASA I-II non-cardiac surgery patients. Neither sevoflurane nor desflurane have major effects on microcirculation in this patient population.