[Rapid induction with vecuronium/fentanyl combinations for coronary artery surgery: influence on cardiovascular responses and plasma fentanyl concentrations].
Cardiovascular effects of fentanyl (60 micrograms.kg-1.min-1)/vecuronium combination for rapid induction were studied in fifty five patients for coronary artery bypass grafts. Cardiovascular and cerebral profiles of patients who had rapid fentanyl administration (39 patients) or slow fentanyl administration (15 patients) were compared with base line values and between each group. Plasma samples were assayed for epinephrine, norepinephrine, growth hormone, anti diuretic hormone and fentanyl. There were no differences in all hemodynamic parameters between each group. However, in the rapid administration group, statistically significant changes were detected in the heart rate, cardiac index, stroke volume index and left ventricular stroke work index. The changes in the heart rate were small and returned to the baseline value after sternotomy. A decrease in cardiac index after induction depends on a decrease in stroke volume index rather than in the heart rate. In rapid administration group, the EEG showed low frequency activity within a minute. The hormonal stress responses were significantly attenuated in both groups. High plasma concentrations of fentanyl could be achieved at the intubation. The data demonstrate that rapid induction by fentanyl is safe and convenient.
Department of Anesthesiology, Hyogo Brain and Heart Center, Himeji.
Y
Y
Kiichi
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R
Chuma
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H
Obara
D000758:Anesthesia / Q000379:methods*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000503:physiopathology / Q000601:surgery; D004569:Electroencephalography; D005283:Fentanyl / Q000008:administration & dosage / Q000097:blood* / Q000494:pharmacology*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D014673:Vecuronium Bromide / Q000008:administration & dosage / Q000494:pharmacology*
D014673:Vecuronium Bromide; D005283:Fentanyl