Copyright: Clinics Cardive Publishing (Pty) Ltd. publisher
of Cardiovascular Journal of Africa.
Abstract
Background:
The choice of anaesthetic agent for open-heart surgery (OHS) may influence perioperative physiology and outcomes. This study compared the effects of sevoflurane and propofol on intraoperative parameters and postoperative complications.
Methods: A retrospective analysis was conducted on 202 patients undergoing OHS (propofol: n = 71; sevoflurane: n = 131). Demographic data, intraoperative variables (cardiopulmonary bypass [CPB] duration, aortic cross-clamp time, heparin dose, cardioplegia volume, serial arterial blood gas [ABG] values), and postoperative complications were collected. Statistical analysis included parametric/non-parametric tests and a generalised linear model.
Results: Demographic and baseline characteristics were comparable between groups. No significant differences were found in CPB time, cross-clamp time, or heparin dose. Cardioplegia volume differed significantly (p = 0.025). ABG analysis revealed that pH and O₂ levels were not significantly influenced by anaesthetic type but were affected by gender and surgical phase. CO₂ levels were significantly influenced by anaesthetic type, gender, and time (p < 0.001). Rates of postoperative bleeding/reoperation (propofol: 4.2%; sevoflurane: 4.55%) and other complications showed no significant differences.
Conclusion: Both sevoflurane and propofol demonstrated comparable safety and efficacy in OHS, with no significant differences in major postoperative complications. However, anaesthetic choice and patient gender significantly influenced intraoperative CO₂ dynamics. These findings support the clinical equivalence of both agents while highlighting gender-specific physiological responses that may warrant consideration in perioperative management.
Methods: A retrospective analysis was conducted on 202 patients undergoing OHS (propofol: n = 71; sevoflurane: n = 131). Demographic data, intraoperative variables (cardiopulmonary bypass [CPB] duration, aortic cross-clamp time, heparin dose, cardioplegia volume, serial arterial blood gas [ABG] values), and postoperative complications were collected. Statistical analysis included parametric/non-parametric tests and a generalised linear model.
Results: Demographic and baseline characteristics were comparable between groups. No significant differences were found in CPB time, cross-clamp time, or heparin dose. Cardioplegia volume differed significantly (p = 0.025). ABG analysis revealed that pH and O₂ levels were not significantly influenced by anaesthetic type but were affected by gender and surgical phase. CO₂ levels were significantly influenced by anaesthetic type, gender, and time (p < 0.001). Rates of postoperative bleeding/reoperation (propofol: 4.2%; sevoflurane: 4.55%) and other complications showed no significant differences.
Conclusion: Both sevoflurane and propofol demonstrated comparable safety and efficacy in OHS, with no significant differences in major postoperative complications. However, anaesthetic choice and patient gender significantly influenced intraoperative CO₂ dynamics. These findings support the clinical equivalence of both agents while highlighting gender-specific physiological responses that may warrant consideration in perioperative management.
Keywords:
anaesthetic agents, open-heart surgery, postoperative complications, gender differences, arterial blood gas analysis
Submitted: April 10, 2026;
Accepted: May 26, 2026;
Published: July 31, 2026
Cardiovasc J Afr 2025; 37: 293-297
Volume 37, Issue 3
Cardiovasc J Afr 2025; 37: 293-297
Volume 37, Issue 3
DOI Citation Reference: dx.doi.org/10.5830/CVJA-2026-030