Arterial hypertension following coronary artery surgery: influence of the narcotic agent used for anaesthesia
| Autor: | P. Sahab, B. Paiement, M. Delorme, J. Taillefer, J. G. Maillé, Marcel Boulanger, Jean-François Hardy |
|---|---|
| Rok vydání: | 1983 |
| Předmět: |
Adult
Male medicine.medical_specialty Extracorporeal Circulation Narcotic medicine.medical_treatment Nitrous Oxide Anesthesia General Fentanyl Postoperative Complications Anesthesiology medicine Intubation Humans Coronary Artery Bypass Aged Morphine business.industry Extracorporeal circulation General Medicine Middle Aged Surgery Anesthesiology and Pain Medicine medicine.anatomical_structure Anesthesia Hypertension Female business Postoperative Hypertension Preanesthetic Medication medicine.drug Artery |
| Zdroj: | Canadian Anaesthetists' Society journal. 30(4) |
| ISSN: | 0008-2856 |
| Popis: | Mcllvaine et al. reported that morphine anaesthesia (1.5 mg.kg-1) was associated with a lower incidence of postoperative hypertension (3.8 per cent) following coronary artery bypass graft surgery (CABG), compared to 28 per cent when low dosefentanyl (7.5-10 µg.kg-1) and halogenated agents were used for anaesthesia. Since in this earlier study the relative dosage of the narcotics used could not be considered as equivalent we compared the incidence of postoperative hypertension in two groups of 24 patients operated for CABG: one group received morphine 1.5 mg.kg-1 and the other fentanyl 50 µg.kg-1: these doses are considered clinically equivalent. In both groups, patients breathed a mixture of nitrous oxide oxygen (3/2). All patients had normal ventricular function. There was not a single case of postoperative hypertension in the morphine group whereas seven cases occurred in the fentanyl group (29 per cent). The incidence of preoperative hypertension was similar in both groups. During the operation, before the extracorporeal circulation, supplementation of anaesthesia to maintain cardiovascular stability was necessary twice as often in the morphine group as in the fentanyl group (40 vs 19). These results show that morphine anaesthesia prevents postoperative hypertension in CABG; clinically equivalent doses of fentanyl do not. However, during surgery, for the period preceding the extracorporeal circulation, fentanyl seems to be preferable to morphine for the coronary patients. This work suggests that a technique combining both narcotics might be advantageous: fentanyl being used before the extracorporeai circulation and morphine during and after, to prevent the postoperative hypertension, it remains to be determined if such a combination would be effective and would not present untoward effects such as delaying recovery, prolonging intubation period and ICU stay. |
| Databáze: | OpenAIRE |
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