Comparison of the cardiovascular effects of isoflurane and sevoflurane as measured by magnetic resonance imaging in children with congenital heart disease

Study Objective: To compare the cardiovascular effects of isoflurane and sevoflurane at minimum alveolar concentration (MAC) = 1 in children with congenital heart disease using cardiac magnetic resonance imaging. Design: Randomized, crossover, single-blinded study. Setting: Tertiary-care teaching hospital. Patients: 10 pediatric patients with congenital heart diseases scheduled to undergo cardiac magnetic resonance studies. Interventions: Patients were randomized to receive either isoflurane or sevoflurane as the "first inhalation agent." After a period or more than 20 minutes, they were crossed over to receive the "second inhalation agent.". Measurements: Heart rate, mean arterial pressure (MAP), cardiac index, stroke volume index, and ejection fraction (EF) at one MAC for both agents were all recorded. Main Results: Both isoflurane and sevoflurane caused a significant decrease in MAP from the baseline (P = 0.013). The mean values (±SD) of stroke volume (mL), cardiac index (L min^-1 m^-2), and EF (%) for isoflurane versus sevoflurane were 21.5 (±9.2) versus 19.6 (±6.2), 4.1 (±1.2) versus 3.7 (±0.87), and 64.2 (±14.5) versus 62.5 (±13.8), respectively. Conclusion: Both isoflurane and sevoflurane were found to be comparable in terms of cardiovascular effects.