Anesthesia Management
Following our institutional protocol, anesthesia was induced with
fentanyl, propofol, and rocuronium and was maintained with sevoflurane
and fentanyl. Lungs were ventilated mechanically with a tidal volume of
6 to 8 mL/kg with a positive end-expiratory pressure of ≥ 5 mbar,
maintaining normoxia and normocapnia. Patients were restricted to a
maximum of 500 mL of balanced crystalloid infusion till intraoperative
echocardiography. All echocardiographic measurements were performed
without any influence of inotropic or vasopressor support and pacing.
All echocardiographic studies were performed under stable hemodynamics
and in sinus rhythm. Following the standards of our institutional
hemodynamics protocol mean arterial blood pressure (MAP) and central
venous pressure (CVP) were maintained establishing stable hemodynamics
(MAP 60-80 mmHg, CVP 4-12 mmHg).