A comparison of the myocardial metabolic and haemodynamic changes produced by propofol-sufentanil and enflurane-sufentanil anaesthesia for patients having coronary artery bypass graft surgery
| Autor: | J. Thomas Murphy, Laurie Poole, Emerson A. Moffitt, Richard I. Hall, Roderick W. Landymore, P. Timothy Pollak |
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| Rok vydání: | 1991 |
| Předmět: |
Adult
Male medicine.medical_specialty Hydrocortisone Sufentanil Hemodynamics Enflurane Coronary Circulation Medicine Humans Prospective Studies Coronary Artery Bypass Propofol Heart metabolism Triglycerides Aged Anesthetics Ejection fraction business.industry Myocardium Heart General Medicine Middle Aged Surgery Fentanyl Anesthesiology and Pain Medicine Blood pressure Liver Anesthesia Anesthesia Recovery Period Anesthesia Intravenous Female Liver function business Anesthesia Inhalation Lipoproteins HDL medicine.drug |
| Zdroj: | Canadian journal of anaesthesia = Journal canadien d'anesthesie. 38(8) |
| ISSN: | 0832-610X |
| Popis: | The purpose of this study was to compare propofol-sufentanil with enflurane-sufentanil anaesthesia for patients undergoing elective coronary artery bypass graft (CABG) surgery with respect to changes in (1) haemodynamic variables; (2) myocardial blood flow and metabolism; (3) serum cortisol, triglyceride, lipoprotein concentrations and liver function; and (4) recovery characteristics. Forty-seven patients with preserved ventricular function (ejection fraction greater than 40%, left ventricular end diastolic pressure less than or equal to 16 mmHg) were studied. Patients in Group A (n = 24) received sufentanil 0.2 microgram.kg-1 and propofol 1-2 mg.kg-1 for induction of anaesthesia which was maintained with a variable rate propofol (50-200 micrograms.kg-1.min-1) infusion and supplemental sufentanil (maximum total 5 micrograms.kg-1). Patients in Group B (n = 23) received sufentanil 5 micrograms.kg-1 for induction of anaesthesia which was maintained with enflurane and supplemental sufentanil (maximum total 7 micrograms.kg-1). Haemodynamic and myocardial metabolic profiles were determined at the awake-sedated, post-induction, post-intubation, first skin incision, post-sternotomy, and pre-cardiopulmonary bypass intervals. Induction of anaesthesia produced a larger reduction in systolic blood pressure in Group A (156 +/- 22 to 104 +/- 20 mmHg vs 152 +/- 26 to 124 +/- 24 mmHg; P less than 0.05). No statistical differences were detected at any other time or in any other variable including myocardial lactate production (n = 13 events in each group), time to tracheal extubation and time to discharge from the ICU. We concluded that, apart from hypotension on induction of anaesthesia, propofol-sufentanil anaesthesia produced anaesthetic conditions equivalent to enflurane-sufentanil anaesthesia for CABG surgery. |
| Databáze: | OpenAIRE |
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