The anaesthetic support for various types of cardiac surgery such as coronary artery bypass grafting, heart valve repair or replacement is essential for success of a surgery. The planning of anaesthesia depends on the intended surgical procedure. The traditional approach is total intravenous anesthesia with propofol and inhalation with sevoflurane.<br /> <b>Objectives: </b>To identify the advantages and disadvantages of propofol and sevoflurane when cardiac surgery in adults. &nbsp;<br /> <b>Material and methods: </b>A total of<b> </b>40 patients were assigned randomly into two groups to receive: in Group 1 - propofol and in Group 2 - sevoflurane. The induction to general anesthesia started with intravenous fractional administration of 1-1.5 mg/kg propofol, 5-7 µg/kg fentanyl and 1.5-2 mg/kg ketamine. Pipecuronium bromide 0.07-0.1 mg/kg was used as a myorelaxant in all patients in both groups. The anaesthesia in group P was supported with propofol 4-6 mg/kg/min intravenously by means of a perfusor as anaesthetic. In group 2, sevoflurane at a dose of 1.7-1.9 MAC was used as an anaesthetic. To maintain anaesthesia in both groups, there was a fractional administration of fentanyl at a dose of 100 µg intravenously when the heart rate and blood pressure increase, piperonium bromide in a dose of 2 mg intravenously was used for muscle relaxation.<br /> <b>Results: </b>The mean arterial pressure, oxygen demand, energy expenditure, cardiac index, total peripheral resistance showed statistically significant differences between propofol and sevoflurane groups. Through the correlation analysis, the relationship between cardiac index and oxygen consumption was moderately relevant, as R was 0.4 and P&gt;0.05.<br /> <b>Conclusion</b>: When the use of sevoflurane for anesthesia, the hemodynamic parameters were stable. The oxygen consumption, energy expenditure in patients were significantly lower compared to propofol using the sevoflurane anesthesia.

Background: Cardiac index (CI) and metabolic response to surgery are important indicators of the course of the intraoperative period. Objectives: This study aimed to determine the effect of sevoflurane, isoflurane, and propofol on CI and metabolic outcomes during aortic and mitral valve replacement in adults. Methods: In this single-center prospective randomized controlled clinical study, a total of 75 patients were randomly assigned into 3 groups according to the type of anesthesia: the propofol group (n = 25), the sevoflurane group (n = 25), and the isoflurane group (n = 25). Cardiac stroke volume (SV) was determined by intraesophageal echocardiography (SV = end-diastolic volume – end-systolic volume). Cardiac output (CO) and CI were calculated according to the formulas. Oxygen consumption during surgery = CI × arteriovenous difference. Indirect calorimetry was used to determine energy expenditure during anesthesia using a spirometry device. Results: The use of anesthetics did not change CI. Cardiac index decreased from 3 to 2.9 L/min/m2 in the propofol group, increased from 3.1 to 3.2 L/min/m2 in the sevoflurane group, and decreased from 2.9 to 2.7 L/min/m2 in the isoflurane group. Compared to inhaled anesthetics, propofol significantly reduced VO2 from 179.1 to 135.7 mL/min/m2. Propofol reduced energy expenditure from 1483.7 to 1333.5 kcal. Conclusions: Volatile anesthetics, propofol has practically no effect on CI in an uncomplicated surgery. Anesthesia with propofol is associated with lower VO2 and better oxygen delivery to tissues. Energy consumption during propofol anesthesia decreases.