Influence of Anesthetics on Clinical Outcome in Mitral and Aortic Valve Replacement in Adults

Abstract Anaesthetic support for cardiac surgery significantly influences the course of the intraoperative period and the success of the postoperative period. Total intravenous anaesthesia and inhalation anaesthesia are the traditional methods of anaesthesia in cardiac surgery. However, there are few studies assessing the effectiveness of surgical aggression protection in cardiac surgery.Objectives: To study the effect of anesthetics on clinical outcome after mitral and aortic valve replacement in adults.Methods. The data of 75 patients operated in the Cardiosurgery Department of the Medical Center Hospital of the Presidential Administration of the Republic of Kazakhstan were included in the study. All patients underwent mitral, aortic valve replacement/plasty under cardiopulmonary bypass (CPB) conditions.All patients were divided into 3 groups according to the type of anaesthesia: the first (1) group patients anaesthetised with propofol (P), the second group with sevoflurane (S), and the last one is with isoflurane (I).To maintain anaesthesia in Group 1 propofol was used as anaesthetic in a dose of 6 mg/kg/h intravenously on perfusion. In Group 2 the anaesthetic used was sevoflurane in a dose of 1.7-1.9 MAC. Group 3 used isoflurane in the dose of 1.1-1.2 MAC as anaesthetic. Statistical analysis was done by the method of single factor analysis of variance and Kruskal Wallis criterion.

Inclusion Criteria:The age is between 40-60 years old;Mitral valve insufficiency grade 3-4;Aortic valve insufficiency grade 3-4;Participants of both sexes will be included in the study;Signed informed consent.Exclusion Criteria:pregnancy (risk to the baby and the mother)allergenic patients (anaphylactic shock).vulnerable groups.current congestive heart failure;current unstable angina pectoris;preoperative hemodynamic instability, defined as the use of vasopressors;