Propofol and fentanyl anaesthesia for patients with low cardiac output state undergoing cardiac surgery: comparison with high-dose fentanyl anaesthesia.
We have compared the haemodynamic effects of an infusion of propofol 8 mg kg-1 h-1 followed by 4 mg kg-1 h-1 and fentanyl 15 micrograms kg-1 (group 1) with midazolam 3-6 mg and fentanyl 60 micrograms kg-1 (group 2) in patients with a low cardiac output state undergoing cardiac surgery. Heart rate was lower in group 1 throughout the period before cardiopulmonary bypass. There were no significant differences between the groups in other measured variables. Arterial pressure decreased in both groups after induction, by 21% in group 1 and 18% in group 2. Thermodilution assessment of right ventricular ejection fraction was unchanged. Myocardial contractility was not affected adversely. Patients in group 1 who received an infusion of propofol and a smaller dose of fentanyl awakened sooner and the trachea was extubated earlier.
Bell
J
J
Northern General Hospital, Sheffield.
Sartain
J
J
Wilkinson
G A
GA
Sherry
K M
KM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000762:Anesthesia Recovery Period; D000771:Anesthesia, Intravenous / Q000379:methods*; D002303:Cardiac Output, Low / Q000503:physiopathology*; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D004334:Drug Administration Schedule; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage*
D005283:Fentanyl; D015742:Propofol